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Individual

EDWARD HARRISON JUDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
325 DANBURY RD, NEW MILFORD, CT 06776-4344
(203) 748-5689
Mailing address
14 GELSTON AVE FL 1, BROOKLYN, NY 11209-5213

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3827
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3827
STATE OF CONNECTICUT
CT
Enumeration date
11/11/2019
Last updated
12/12/2022
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