Organization
WAVES OF CHANGE COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CHRYSTAL LONG LPC (LICENSED PROFESSIONAL COUNSELOR)
(203) 677-0919
Entity
Organization
Contact information
Practice address
92 N SUMMIT ST STE 2E, SOUTHINGTON, CT 06489-3000
(203) 677-0919
Mailing address
92 N SUMMIT ST STE 2E, SOUTHINGTON, CT 06489-3000
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002045
CT
Other
Enumeration date
03/26/2018
Last updated
03/26/2018
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