Organization
RUTH ETCHELLS SIBORG LPC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUTH ETCHELLS SIBORG LPC (COUNSELOR)
(860) 207-7464
Entity
Organization
Contact information
Practice address
100 LINWOOD AVE, COLCHESTER, CT 06415-1138
(860) 207-7464
Mailing address
36 HI LEA FARM RD, COLCHESTER, CT 06415-1779
(860) 207-7464
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
03/07/2019
Last updated
03/07/2019
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