Organization
TMW WELLNESS PLLC
Active
Parent organization
THE MODERN WOMAN HEALTH & WELLNESS CENTER PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE MODERN WOMAN HEALTH & WELLNESS CENTER PLLC
Authorized official
SHIVANNA SUBRAMANI-GONZALEZ FNP (CMO)
(203) 725-5339
Entity
Organization
Contact information
Practice address
504 WOLCOTT RD, WOLCOTT, CT 06716-2461
(203) 504-9507
Mailing address
504 WOLCOTT RD, WOLCOTT, CT 06716-2461
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/28/2023
Last updated
03/29/2023
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