NEW PROVENANCE COUNSELING CENTER, LLC

MANCHESTER, CT
NPI1457949687
Entity TypeOrganization
Authorized ContactMICHELLE WORTHAM
Owner
959-222-8548
Organization Subpart ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
Enumeration Date2021-01-04
Last Update Date2021-01-04
Business Address
NEW PROVENANCE COUNSELING CENTER, LLC
22 SAINT JAMES ST APT G
MANCHESTER, CT 06040-5957
Phone number: 959-222-8548
Mailing Address
NEW PROVENANCE COUNSELING CENTER, LLC
22 SAINT JAMES ST APT G
MANCHESTER, CT 06040-5957
Phone number: 959-222-8548
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