Individual
LESLIE E WILBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCC
Contact information
Practice address
446 BLAKE ST # 200, NEW HAVEN, CT 06515-4407
(203) 387-9400
Mailing address
15 FISCO DR, EAST HAVEN, CT 06513-1202
(917) 557-6071
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
46.004839
CT
101YP2500X
Professional Counselor
Primary
46.004839
CT
Other
Enumeration date
04/07/2021
Last updated
01/04/2023
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