Individual
ROSEANNE MASCOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
440D NORTH MAIN ST, BRISTOL, CT 06010
(860) 314-2052
(860) 314-2054
Mailing address
PO BOX 2828, BRISTOL, CT 06011
(860) 585-3906
(860) 585-3907
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000559
CT
Other
Enumeration date
06/09/2006
Last updated
07/11/2007
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