Individual
JULIE JASON FARRELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
45 WINTONBURY AVE STE 102, BLOOMFIELD, CT 06002
(860) 707-2024
Mailing address
PO BOX 212, SOUTH WINDSOR, CT 06074-0212
(860) 707-2024
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/19/2012
Last updated
07/12/2019
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