Individual
JOHN LEROY FORLENZA-BAILEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
71 HAYNES ST, MANCHESTER, CT 06040-4131
(860) 646-1222
(860) 533-3452
Mailing address
230 QUAKER LN N, WEST HARTFORD, CT 06119-1149
(860) 232-0301
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000353
CT
Other
Enumeration date
04/01/2006
Last updated
07/08/2007
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