Individual
MRS. JESSICA NIEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
62 CARTER RD, KENT, CT 06757-0607
(860) 927-3772
Mailing address
PO BOX 607, KENT, CT 06757-0607
(860) 927-3772
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
001387
CT
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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