Individual
LISA CORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
53 MUIR AVE, BRISTOL, CT 06010-7215
(860) 582-7904
(860) 582-4350
Mailing address
53 MUIR AVE, BRISTOL, CT 06010-7215
(860) 380-7470
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2910
CT
Other
Enumeration date
03/01/2016
Last updated
03/01/2016
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