Individual
MS. GERTRUDE ELLEN SUPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
50 BROOKSIDE ROAD, WATERBURY, CT 06708-1402
(203) 755-4490
Mailing address
92 FELDSPAR AVE, BEACON FALLS, CT 06403-1439
(203) 723-8772
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/27/2008
Last updated
08/27/2008
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