Individual
LATISHA BROCKINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-A
Contact information
Practice address
855 LAKEWOOD RD, WATERBURY, CT 06704-5408
(888) 793-3500
Mailing address
730 HIGH ST, NAUGATUCK, CT 06770-3241
(203) 490-9258
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6846
CT
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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