Individual
JACQUELINE BANASIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
45 S MAIN ST, WEST HARTFORD, CT 06107-2441
(860) 414-4245
Mailing address
59 WOOD CREEK RD, BURLINGTON, CT 06013-1920
(860) 395-9857
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3023
CT
Other
Enumeration date
10/13/2016
Last updated
10/15/2016
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