| Authentic Balance Consortium Llc | |
|
267 Willimantic Rd Suite 5 Chaplin CT 06235-2516 | |
| (860) 617-2848 | |
| Not Available |
| Full Name | Authentic Balance Consortium Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 267 Willimantic Rd, Chaplin, Connecticut |
| Authorized Official Name and Position | Diane Tarricone (PARTNER) |
| Authorized Official Contact | 8606172848 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Authentic Balance Consortium Llc 267 Willimantic Rd Suite 5 Chaplin CT 06235-2516 Ph: (860) 617-2848 | Authentic Balance Consortium Llc 267 Willimantic Rd Suite 5 Chaplin CT 06235-2516 Ph: (860) 617-2848 |
| NPI Number | 1538347349 |
|---|---|
| Provider Enumeration Date | 02/04/2008 |
| Last Update Date | 02/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538347349 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 001484 (Connecticut) | Primary |
| 1041C0700X | Social Worker - Clinical | 006609 (Connecticut) | Secondary |
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