Individual
JATARRA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-A
Contact information
Practice address
255 BANK ST FL 4, WATERBURY, CT 06702-2219
(203) 596-9724
Mailing address
255 BANK ST FL 4, WATERBURY, CT 06702-2219
(203) 596-9724
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6792
CT
Other
Enumeration date
03/20/2024
Last updated
08/12/2024
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