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Individual

TAVIA-SIMONE BASCUINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
300 BOSTON POST RD, WEST HAVEN, CT 06516
(203) 932-7330
Mailing address
115 MAIN STREET, #143, EAST BERLIN, CT 06023
(203) 932-7330

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
58.010762
CT
101YM0800X
Mental Health Counselor
MSW.002363
CT

Other

Enumeration date
08/19/2015
Last updated
08/16/2022
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