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General NPI Number Information
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NPI Number | 1205582376
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Entity Type | Individual
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Provider Name | VELMARY VARGAS LADC
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Gender | Female
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Dates
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Enumeration Date | 02/26/2022
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Last Update Date | 02/26/2022
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Provider Practice Location Address
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Address Line | 50 BROOKSIDE RD
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City | WATERBURY
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State | CT
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Zip | 06708-1402
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Country | US
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Telephone | 203-568-7474
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Fax |
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Provider Business Mailing Address
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Address Line | 163 SHAW FARM RD
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City | OAKVILLE
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State | CT
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Zip | 06779-1469
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Country | US
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Telephone | 203-805-1886
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1438
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License Number State | CT
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