Individual
ABDUL JALIL SHABAZZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
187 S CANAAN RD, CANAAN, CT 06018-2544
(860) 824-1397
(888) 764-6211
Mailing address
75 RUSTLING REED RD, NAUGATUCK, CT 06770-3539
(203) 525-1265
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
07/19/2016
Last updated
07/19/2016
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