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Individual

MR. KENDALL RICHARDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LADC

Contact information

Practice address
228 MEADOW ST, SUITE 201, WATERBURY, CT 06702-1807
(203) 597-0643
(203) 597-0834
Mailing address
38 OLD RIDGEBURY RD, DANBURY, CT 06810-5128
(203) 792-4515
(203) 748-2604

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000483
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008017939
CT
Enumeration date
11/14/2006
Last updated
12/14/2011
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