National Provider Identifier Database

WATERTOWN WELLNESS CENTER LLC
Professional


Contact Information

WATERTOWN WELLNESS CENTER LLC
116 GEORGETOWN DRIVE
WATERTOWN, CT06795
Phone: 203-592-7898
Fax:
Website:
Specialty Taxonomy Code
* Professional 101YP2500X
Community/Behavioral Health 251S00000X

* Indicates primary specialty

NPI Profile & details for WATERTOWN WELLNESS CENTER LLC

NPI Number 1396232187
Legal business name
LBN
WATERTOWN WELLNESS CENTER LLC
Authorized official LAURA MANDERINO - (OWNER/LICENSED PSYCHOTHERAPIST)
Entity Organization
Organization subpart No
Enumeration date 04/17/2018
Last updated 04/17/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • CT License #: 003013

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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