Individual
LATASHA GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
816 BROAD ST, SUITE 23, MERIDEN, CT 06450-4350
(203) 630-2499
(203) 630-2499
Mailing address
70 CRANBERRY LN, CHESHIRE, CT 06410-3503
(203) 630-2488
(203) 630-2499
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2820
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008062953
—
CT
Enumeration date
04/29/2016
Last updated
04/29/2016
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