Individual
ASHLEY BRUCKENTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 DEEPWOOD DR, BETHEL, CT 06801-1267
(203) 927-8907
Mailing address
54 DANBURY RD STE 337, RIDGEFIELD, CT 06877-4019
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
P03381
NY
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336163963
—
NY
Enumeration date
08/30/2016
Last updated
09/02/2022
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