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Individual

RHONDA WATSON-DEJESUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADC

Contact information

Practice address
495 CONGRESS AVE, NEW HAVEN, CT 06519-1312
(203) 781-4600
(203) 781-4624
Mailing address
1 LONG WHARF DR, NEW HAVEN, CT 06511-5991
(203) 781-4600
(203) 781-4624

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1303
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004082260
CT
05
008001325
CT
05
008022622
CT
05
008056033
CT
Enumeration date
08/20/2018
Last updated
10/23/2018
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