Individual
ANA VIRGINIA TAVERAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
968 FAIRFIELD AVE, BRIDGEPORT, CT 06605-1116
(203) 330-6000
Mailing address
46 ALBION ST, BRIDGEPORT, CT 06605-2602
(203) 330-6000
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5884
CT
Other
Enumeration date
12/22/2021
Last updated
09/10/2024
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