Individual
MRS. MARYELLEN T ESTRADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
240 WARDWELL ST APT 24, STAMFORD, CT 06902-5241
(203) 962-4929
Mailing address
240 WARDWELL ST APT 24, STAMFORD, CT 06902-5241
(203) 962-4929
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
001332
CT
Other
Enumeration date
03/13/2022
Last updated
03/13/2022
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