Individual
THERESA ALECIA ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
350 CENTER ROCK GRN STE 9, OXFORD, CT 06478-3170
(860) 532-8222
Mailing address
281 BURGUNDY HILL LN, MIDDLETOWN, CT 06457-6372
(860) 532-8222
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
004843
CT
Other
Enumeration date
12/03/2020
Last updated
04/12/2021
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