| Illuminate Therapy Llc | |
|
2 Klarides Village Dr # 272 Seymour CT 06483-2737 | |
| (203) 490-7943 | |
| Not Available |
| Full Name | Illuminate Therapy Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2 Klarides Village Dr # 272, Seymour, Connecticut |
| Authorized Official Name and Position | Laura Lee Davis (CLINICIAN) |
| Authorized Official Contact | 2034907943 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illuminate Therapy Llc 2 Klarides Village Dr # 272 Seymour CT 06483-2737 Ph: (203) 490-7943 | Illuminate Therapy Llc 2 Klarides Village Dr # 272 Seymour CT 06483-2737 Ph: (203) 490-7943 |
| NPI Number | 1235808221 |
|---|---|
| Provider Enumeration Date | 09/13/2021 |
| Last Update Date | 09/13/2021 |
| Certification Date | 08/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235808221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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