Organization
WAVES OF GROWTH THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKAYLA SLEETER LPC (LICENSED PROFESSIONAL COUNSELOR)
(860) 705-9984
Entity
Organization
Contact information
Practice address
2 CHAPMAN LN STE F, GALES FERRY, CT 06335-1200
(860) 705-9984
Mailing address
17 RAMBLEWOOD DR, GALES FERRY, CT 06335-1641
(860) 705-9984
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831558550
NPI NUMBER
—
Enumeration date
10/18/2019
Last updated
10/18/2019
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