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Individual

JENNIFER B MELQUIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LPC

Contact information

Practice address
91 NORTHWEST DR, PLAINVILLE, CT 06062-1534
(860) 793-4413
Mailing address
41 KENSINGTON ST, MANCHESTER, CT 06040-5421
(860) 305-6164

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
001277
CT

Other

Enumeration date
02/16/2007
Last updated
02/04/2011
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