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Individual

THERESA NAOMIMA SIMBOLON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
300 CHURCH ST, WALLINGFORD, CT 06492
(203) 314-0940
Mailing address
301 WINCHESTER AVE APT 104, NEW HAVEN, CT 06511-8054

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9825
CT

Other

Enumeration date
06/15/2026
Last updated
06/15/2026
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