Organization
NEW ROAD WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA LAGGIS PMHNP-BC (OWNER)
(860) 227-5725
Entity
Organization
Contact information
Practice address
7 MICHAEL DR, CLINTON, CT 06413-1068
(203) 318-6484
(203) 318-6484
Mailing address
24 W MAIN ST STE 357, CLINTON, CT 06413-2053
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376081570
PMHNP-BC
CT
01
—
6934
NURSE PRACTITIONER
CT
Enumeration date
05/03/2019
Last updated
06/15/2021
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