Individual
ELAINE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
36 RUSSELL ST, LIFELINE FOR WOMEN AND CHILDREN, NEW BRITAIN, CT 06052-1313
(860) 223-8885
Mailing address
36 RUSSELL ST, LIFELINE FOR WOMEN AND CHILDREN, NEW BRITAIN, CT 06052-1313
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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