Provider Demographics
NPI:1467696039
Name:CONNECTICUT NATURAL HEALTH SPECIALISTS LLC
Entity Type:Organization
Organization Name:CONNECTICUT NATURAL HEALTH SPECIALISTS LLC
Other - Org Name:PRAGMATIC UTOPIA LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOUIN
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:860-428-0535
Mailing Address - Street 1:25 CONCORD ST
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2135
Mailing Address - Country:US
Mailing Address - Phone:860-428-0535
Mailing Address - Fax:
Practice Address - Street 1:25 CONCORD ST
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2135
Practice Address - Country:US
Practice Address - Phone:860-428-0535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-27
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000397175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty