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General NPI Number Information
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NPI Number | 1174486864
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Entity Type | Individual
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Provider Name | MARISKA JEN MIESSLER
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Gender | Female
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 2 CORPORATE DR STE 950
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City | SHELTON
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State | CT
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Zip | 06484-6246
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Country | US
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Telephone | 203-293-0224
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Fax |
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Provider Business Mailing Address
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Address Line | 363 SUMMERFIELD GDNS
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City | SHELTON
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State | CT
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Zip | 06484-6306
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Country | US
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Telephone | 562-477-4952
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 9182
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License Number State | CT
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