| Embodying Redemption | |
|
495 Orange St New Haven CT 06511-3809 | |
| (206) 321-8555 | |
| Not Available |
| Full Name | Embodying Redemption |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 495 Orange St, New Haven, Connecticut |
| Authorized Official Name and Position | Laura Wallace (OWNER) |
| Authorized Official Contact | 2063218555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Embodying Redemption 872 State St Apt 3d New Haven CT 06511-7310 Ph: (206) 321-8555 | Embodying Redemption 495 Orange St New Haven CT 06511-3809 Ph: (206) 321-8555 |
| NPI Number | 1093058257 |
|---|---|
| Provider Enumeration Date | 04/05/2013 |
| Last Update Date | 10/16/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093058257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 1470 (Connecticut) | Primary |
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