Individual
SHILOH RAE EZZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPCA
Contact information
Practice address
586 MAIN ST, NEW BRITAIN, CT 06051-1812
(860) 225-4641
Mailing address
243 LAZY LN, SOUTHINGTON, CT 06489-1731
(860) 301-8544
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4451
CT
Other
Enumeration date
06/10/2021
Last updated
06/10/2021
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