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Individual

MR. JASON C BEDFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LADC

Contact information

Practice address
605 WASHINGTON AVE, NORTH HAVEN, CT 06473-1123
(203) 836-6570
Mailing address
168 NORTONTOWN RD, MADISON, CT 06443-1924
(203) 836-6570

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
001409
CT

Other

Enumeration date
06/16/2021
Last updated
06/16/2021
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