Individual
TERRY ROTH PERREAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
33 HIGHLAND ST, NEW BRITAIN, CT 06052-2013
(860) 224-9985
(860) 826-4995
Mailing address
33 HIGHLAND ST, NEW BRITAIN, CT 06052-2013
(860) 224-9985
(860) 826-4995
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PC0000327
DE
101YP2500X
Professional Counselor
Primary
001640
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000035004
—
DE
Enumeration date
11/29/2006
Last updated
06/23/2008
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