Individual
MS. BETH B AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5 SCHOOL ST, MYSTIC, CT 06355-2717
(860) 572-0667
(860) 572-0667
Mailing address
PO BOX 253, OLD MYSTIC, CT 06372-0253
(860) 572-0667
(860) 572-0667
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
004996
CT
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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