Organization Name: | WANDEMBERGH MENTAL HEALTH SERVICES, LLC |
NPI Number: | 1003071275 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HECTOR CHANES (CLINICAL PSYCHOLOGIST / PRESIDENT) |
Mailing Address: | 206 Wells St Manchester |
State: | CT US |
Postal Code: | 060406152 |
Phone Number: | 8606435387 |
Fax Number: | 8606435387 |
NPI Enumeration Date: | 07/27/2008 |
NPI Last Update Date: | 07/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 002846 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |