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Individual

MARY ELLEN STAUDT SPITZFADEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
21 BRIDGE SQ, WESTPORT, CT 06880-5900
(203) 554-4091
Mailing address
21 BRIDGE SQ, WESTPORT, CT 06880-5900
(203) 554-4091
(203) 554-4091

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
003152
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004066985
CT
Enumeration date
04/03/2017
Last updated
11/23/2021
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