Organization
CHILDREN'S BEHAVIORAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIEZER SONTAG (MEMBER)
(917) 621-7360
Entity
Organization
Contact information
Practice address
104 BLUERIDGE DRIVE EXT, WATERBURY, CT 06704-6122
(917) 621-7360
Mailing address
104 BLUERIDGE DRIVE EXT, WATERBURY, CT 06704-6122
(917) 621-7360
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
002599
CT
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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