Individual
MISS DONNA MARIE UNDERHILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC MSW
Contact information
Practice address
5 BAYVIEW PL FL 1, WEST HAVEN, CT 06516-4702
(475) 422-4361
Mailing address
5 BAYVIEW PL FL 1, WEST HAVEN, CT 06516-4702
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
001249
CT
Other
Enumeration date
10/22/2017
Last updated
10/22/2017
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