Individual
DANIELLE FORKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
445 WASHINGTON AVE, NORTH HAVEN, CT 06473-1320
(203) 658-7779
Mailing address
176 AMITY RD # 234, WOODBRIDGE, CT 06525-2239
(860) 262-0555
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001884
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250938
—
CT
Enumeration date
03/28/2018
Last updated
03/28/2018
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