Individual
DIANE HEYWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 MIDLAND RD, WATERBURY, CT 06705-3412
(203) 755-8874
Mailing address
4 MIDLAND RD, WATERBURY, CT 06705-3412
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000790
CT
Other
Enumeration date
01/06/2012
Last updated
01/06/2012
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