Individual
TATIANA Y JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 DOVER ST, BRIDGEPORT, CT 06610-2277
(929) 669-7281
Mailing address
401 DOVER ST, BRIDGEPORT, CT 06610-2277
(929) 669-7281
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
Primary
—
CT
Other
Enumeration date
10/09/2025
Last updated
10/09/2025
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