Organization
WHOLE HEALTH WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER S BOSCO LPC (MEMBER/OWNER)
(860) 662-1933
Entity
Organization
Contact information
Practice address
139 MILL ROCK RD E UNIT 1522, OLD SAYBROOK, CT 06475
(860) 662-1933
Mailing address
7 N MAIN ST UNIT 1522, OLD SAYBROOK, CT 06475-4244
(860) 662-1933
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
001695
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008026193
—
CT
Enumeration date
01/04/2011
Last updated
08/15/2018
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