Provider Demographics
NPI:1962128280
Name:ALMA MIA WELLNESS LLC
Entity type:Organization
Organization Name:ALMA MIA WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MIA
Authorized Official - Middle Name:YADIRA
Authorized Official - Last Name:BREULER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-464-2846
Mailing Address - Street 1:110 VISTA TER
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-2472
Mailing Address - Country:US
Mailing Address - Phone:203-464-2846
Mailing Address - Fax:
Practice Address - Street 1:110 VISTA TER
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-2472
Practice Address - Country:US
Practice Address - Phone:203-464-2846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health