Individual
CASSANDRA CHARLES-TABACCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
180 FAIRFIELD AVE, BRIDGEPORT, CT 06604-4252
(203) 394-6529
(203) 610-6131
Mailing address
180 FAIRFIELD AVE, BRIDGEPORT, CT 06604-4252
(203) 394-6529
(203) 610-6131
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06-0669106
—
CT
Enumeration date
06/20/2017
Last updated
07/21/2022
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