Individual
AUDREY BAEHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
121 WAKELEE AVENUE, ACS, ANSONIA, CT 06401-1198
(203) 503-3650
(203) 503-3659
Mailing address
12 PRIMROSE DR, TRUMBULL, CT 06611-5040
(203) 767-4594
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
994
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235918
—
CT
Enumeration date
01/23/2020
Last updated
01/27/2020
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