Organization
LEARN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIRGINIA SECCOMBE (EXECUTIVE DIRECTOR)
(860) 434-4800
Entity
Organization
Contact information
Practice address
44 HATCHETTS HILL RD, OLD LYME, CT 06371-1512
(860) 434-4800
(860) 434-4834
Mailing address
44 HATCHETTS HILL RD, OLD LYME, CT 06371-1512
(860) 434-4800
(860) 434-4834
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004185858
—
CT
Enumeration date
03/21/2007
Last updated
04/09/2010
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