| Lacc LLC | |
|
1140 Johnson Rd Woodbridge CT 06525-2619 | |
| (203) 910-2934 | |
| Not Available |
| Full Name | Lacc LLC |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1140 Johnson Rd, Woodbridge, Connecticut |
| Authorized Official Name and Position | Drea Louise Gordon (OWNER) |
| Authorized Official Contact | 2039102934 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lacc LLC 1140 Johnson Rd Woodbridge CT 06525-2619 Ph: (203) 910-2934 | Lacc LLC 1140 Johnson Rd Woodbridge CT 06525-2619 Ph: (203) 910-2934 |
| NPI Number | 1487401063 |
|---|---|
| Provider Enumeration Date | 05/02/2024 |
| Last Update Date | 05/02/2024 |
| Certification Date | 05/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487401063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (NU) | Primary |
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