Individual
AUDRA VAN TASSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
64 THOMPSON ST # A-103104, EAST HAVEN, CT 06513-5707
(203) 691-1685
Mailing address
64 THOMPSON ST # A-103104, EAST HAVEN, CT 06513-5707
(203) 691-1685
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4935
CT
Other
Enumeration date
06/28/2021
Last updated
06/28/2021
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