Individual
ASHLEY PICKNELLY VASSALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
880 BURBANK AVE, SUFFIELD, CT 06078-1459
(413) 530-7038
Mailing address
14 LISE CIR, SUFFIELD, CT 06078-1381
(413) 530-7038
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6932
CT
Other
Enumeration date
02/27/2023
Last updated
02/27/2023
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