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Individual

MRS. JORDAN SILEO WASIK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
191 ALBANY TPKE STE 307, CANTON, CT 06019-2554
(860) 461-9914
Mailing address
97B DYER AVE, COLLINSVILLE, CT 06019-3233
(860) 384-4483

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary
3093
CT
101YM0800X
Mental Health Counselor

Other

Enumeration date
04/27/2015
Last updated
10/21/2021
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