Individual
JEFFREY STICKLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
240 CAVAN LN, GLASTONBURY, CT 06033-2405
(203) 376-9265
Mailing address
240 CAVAN LN, GLASTONBURY, CT 06033-2405
(203) 376-9265
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1068
CT
Other
Enumeration date
02/26/2017
Last updated
02/26/2017
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