Organization
BROOKLAWN WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL SALVATORE GUGLIELMO LCSW (OWNER LICENSED CLINICAL SOCIAL WKR)
(203) 368-0688
Entity
Organization
Contact information
Practice address
1653 CAPITOL AVENUE, BRIDGEPORT, CT 06604
(203) 368-0688
Mailing address
1653 CAPITOL AVENUE, BRIDGEPORT, CT 06604
(203) 368-0688
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
001581
CT
Other
Enumeration date
11/20/2007
Last updated
11/20/2007
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