Individual
MR. PETER W. DEROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
20 MAPLE AVE, UNCASVILLE, CT 06382-2345
(860) 848-3098
(860) 848-1152
Mailing address
20 MAPLE AVE, UNCASVILLE, CT 06382-2345
(860) 848-3098
(860) 848-1152
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
976
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060966963
—
CT
Enumeration date
12/30/2009
Last updated
12/30/2009
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