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Individual
JEFFREY GREENBLATT
Active
Individual
JEFFREY GREENBLATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
001122
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001122
CONNECTICUT DEPT PUBLIC HEALTH
CT
Enumeration date
11/28/2017
Last updated
11/28/2017
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