Individual
SUZANNE DEROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
43 SHERMAN HILL RD STE 103, WOODBURY, CT 06798-3651
(203) 509-8244
Mailing address
42 ARVIDA RD, WOLCOTT, CT 06716-2766
(203) 509-8244
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001350
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194031849
—
CT
Enumeration date
08/19/2010
Last updated
03/17/2018
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