Individual
LISA FOURNIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1046 FAIRFIELD AVE, BRIDGEPORT, CT 06605-1116
(203) 330-6054
(203) 331-4716
Mailing address
1046 FAIRFIELD AVE, BRIDGEPORT, CT 06605-1116
(203) 330-6054
(203) 331-4716
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000959
CT
101YM0800X
Mental Health Counselor
Primary
106H00000X
CT
Other
Enumeration date
05/24/2007
Last updated
04/17/2012
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