Individual
MRS. JESSE D MILLER-KHODIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
62 NEWTON TER, WATERBURY, CT 06708-1919
(860) 961-1354
Mailing address
62 NEWTON TER, WATERBURY, CT 06708-1919
(860) 961-1354
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4392
CT
Other
Enumeration date
04/16/2020
Last updated
02/05/2024
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