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Organization

COASTAL THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERRI FOGG DONOVAN (BILLING DEPT)
(860) 535-9922
Entity
Organization

Contact information

Practice address
428 LONG HILL RD STE 201, GROTON, CT 06340-3811
(860) 614-3548
Mailing address
117 N STONINGTON RD, MYSTIC, CT 06355-3608
(860) 614-3548

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
05/02/2019
Last updated
05/02/2019
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