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NPI Code Detail

MEDICARE: MARY E ST. JUSTE-PROSPER

MEDICARE: MARY E ST. JUSTE-PROSPER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist001942CT

General Provider Information

NPI Number : 1336615137
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY E ST. JUSTE-PROSPER
Provider Business Mailing Address
First Line : 100 EAST AVE
Second Line :
City : NORWALK
State : CT
Zip : 06851-5010
Country : US
Telephone Number : 203-299-1315
Fax Number : 203-299-0015
Provider Business Practice Location Address
First Line : 100 EAST AVE
Second Line :
City : NORWALK
State : CT
Zip : 06851-5010
Country : US
Telephone Number : 203-299-1315
Fax Number : 203-299-0015
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2018
Last Update Date : 09/28/2023

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Directions to “ MARY E ST. JUSTE-PROSPER ” Practice Location

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