Provider First Line Business Practice Location Address:
100 EAST AVENUE
Provider Second Line Business Practice Location Address:
MID FAIRFIELD CHILD GUIDANCE CENTER
Provider Business Practice Location Address City Name:
NORWALK
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-299-1315
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2007