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Individual

MS. LISA MICHELLE SLADE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1115 MAIN ST STE 702, BRIDGEPORT, CT 06604-4406
(203) 334-5500
Mailing address
72 READ ST, BRIDGEPORT, CT 06607-2016
(203) 368-2769

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0001781
CT

Other

Enumeration date
12/27/2008
Last updated
12/27/2008
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