Individual
ANDREA PRAIRIE TULLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
50 ALBANY TURNPIKE, SUITE #5022, CANTON, CT 06019
(860) 490-8084
Mailing address
33 DARTMOUTH DRIVE, CANTON, CT 06019
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001460
CT
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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