Individual
KYISHA KIA VELAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
446A BLAKE STREET, SUITE 200, NEW HAVEN, CT 06515-0651
(203) 387-9400
(203) 387-9400
Mailing address
408 NORTON PKWY, NEW HAVEN, CT 06511-2829
(203) 903-8684
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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