Individual
FREDERICK STREETS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
602 NICHOLS AVE, STRATFORD, CT 06614-3925
(203) 296-2430
Mailing address
602 NICHOLS AVE, STRATFORD, CT 06614-3925
(203) 296-2430
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
002270
CT
Other
Enumeration date
10/19/2019
Last updated
10/19/2019
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