Individual
MS. JENNIFER CORA SLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1630 CROSS HWY, FAIRFIELD, CT 06824-1707
(203) 434-5135
Mailing address
1630 CROSS HWY, FAIRFIELD, CT 06824-1707
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001379
CT
Other
Enumeration date
04/13/2010
Last updated
04/13/2010
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