Provider First Line Business Practice Location Address:
950 CAMPBELL AVE
Provider Second Line Business Practice Location Address:
NATIONAL CENTER FOR PTSD (116A)
Provider Business Practice Location Address City Name:
WEST HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06516-2770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-710-5073
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/14/2011