Individual
MISS AUDREY STGEORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1680 ALBANY AVE, HARTFORD, CT 06105-1001
(860) 236-4513
Mailing address
1021 ASYLUM AVE, APT 211, HARTFORD, CT 06105-2436
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
09/10/2014
Last updated
09/10/2014
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