Individual
GAYATHRI HERATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
860 1ST AVE, WEST HAVEN, CT 06516-2717
(230) 350-3912
Mailing address
860 1ST AVE, WEST HAVEN, CT 06516-2717
(203) 350-3912
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
CT
101YM0800X
Mental Health Counselor
—
CT
Other
Enumeration date
09/22/2014
Last updated
09/22/2014
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