Individual
GEORGETTE QUACKENBUSH HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDM, LPC, NCC
Contact information
Practice address
103 W BROAD ST, STAMFORD, CT 06902-3713
(203) 517-3376
Mailing address
103 W BROAD ST, STAMFORD, CT 06902-3713
(203) 517-3376
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001799
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235918
—
CT
Enumeration date
02/04/2008
Last updated
04/26/2016
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