Individual
PUYLAURENS ALEXIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
352 STATE ST, NORTH HAVEN, CT 06473-3108
(203) 781-4600
(203) 781-4624
Mailing address
1 LONG WHARF DR, NEW HAVEN, CT 06511-5991
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000825
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008038046
—
CT
Enumeration date
12/09/2011
Last updated
06/25/2015
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