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Individual

ISAIAH DARNELL DOCKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1 LONG WHARF DR STE 321, NEW HAVEN, CT 06511-5946
(203) 781-4600
(203) 781-4624
Mailing address
1 LONG WHARF DR STE 321, NEW HAVEN, CT 06511-5946
(203) 781-4600
(203) 781-4624

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1488
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008023170
CT
05
008024427
CT
05
008042339
CT
05
008109605
CT
05
008115789
CT
Enumeration date
01/12/2023
Last updated
02/06/2023
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