Individual
KAYLA NICKERSON GAUTHIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
41 WILLIAMS AVE, MYSTIC, CT 06355
(860) 961-5702
Mailing address
140 ROSS HILL RD, LISBON, CT 06351-2824
(860) 373-8802
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1832
CT
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
08/28/2016
Last updated
06/04/2018
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