Individual
MS. MARY ANN D FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PC
Contact information
Practice address
415 SILAS DEANE HWY STE 220, A BALANCED LIFE COUNSELING CENTER, LLC, WETHERSFIELD, CT 06109-2119
(860) 529-1696
(860) 529-1696
Mailing address
415 SILAS DEANE HWY STE 220, A BALANCED LIFE COUNSELING CENTER, LLC, WETHERSFIELD, CT 06109-2119
(860) 529-1696
(860) 529-1696
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
000949
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240000949CT02
ANTHEM
CT
Enumeration date
06/14/2007
Last updated
11/22/2013
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