Individual
HEATHER E REVILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
98 FAIR DR, SOMERSET, MA 02726-5926
(860) 990-1346
Mailing address
98 FAIR DR, SOMERSET, MA 02726-5926
(860) 990-1346
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002927
CT
Other
Enumeration date
05/07/2019
Last updated
05/07/2019
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