Individual
DR. MISTY M GINICOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., LPC
Contact information
Practice address
672 W MAIN ST, WEST HAVEN, CT 06516-4826
(203) 339-1062
Mailing address
672 W MAIN ST, WEST HAVEN, CT 06516-4826
(203) 339-1062
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
002631
CT
Other
Enumeration date
01/23/2017
Last updated
01/23/2017
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