Healthcare Provider Details

I. General information

NPI: 1477467710
Provider Name (Legal Business Name): ERIN LEE DOBB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

563 WOODBRIDGE ST APT 1
MANCHESTER CT
06042-3607
US

IV. Provider business mailing address

563 WOODBRIDGE ST APT 1
MANCHESTER CT
06042-3607
US

V. Phone/Fax

Practice location:
  • Phone: 860-899-4864
  • Fax:
Mailing address:
  • Phone: 860-899-4864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number24383150
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: