Individual
MS. LISA VENDITTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
12 ROOSEVELT AVE, MYSTIC, CT 06355-2809
(860) 333-4634
Mailing address
72 DENISON AVE, MYSTIC, CT 06355-2730
(860) 333-4634
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
09/11/2006
Last updated
03/08/2017
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