Individual
AUTUMN CHASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCA
Contact information
Practice address
475 CLINTON AVE, BRIDGEPORT, CT 06605-1700
(203) 368-5632
Mailing address
34 PARK CIR, MILFORD, CT 06460-4832
(860) 906-2147
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5044
CT
Other
Enumeration date
02/11/2022
Last updated
02/11/2022
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