Individual
JENNIFER A DERICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
255 HEMPSTEAD ST, NEW LONDON, CT 06320-6204
(860) 443-2896
(860) 442-5909
Mailing address
255 HEMPSTEAD ST, NEW LONDON, CT 06320-6204
(860) 443-2896
(860) 442-5909
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/12/2016
Last updated
09/12/2016
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