Individual
YEZENIA LUNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, CAC
Contact information
Practice address
1046 FAIRFIELD AVE, BRIDGEPORT, CT 06605-1116
(203) 330-6504
(203) 331-4716
Mailing address
301 FUNSTON AVE, BRIDGEPORT, CT 06606-3038
(203) 339-1736
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC 4497
CT
Other
Enumeration date
05/26/2010
Last updated
05/26/2010
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