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General NPI Number Information
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NPI Number | 1275008575
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Entity Type | Individual
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Provider Name | JOANNA GRACE SZYMANSKI
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Gender | Female
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Dates
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Enumeration Date | 10/12/2018
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Last Update Date | 10/12/2018
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Provider Practice Location Address
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Address Line | 1 CARRIAGE PL
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City | WATERBURY
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State | CT
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Zip | 06702-2108
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Country | US
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Telephone | 860-805-2267
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Fax |
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Provider Business Mailing Address
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Address Line | 156 DEER RUN
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City | BURLINGTON
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State | CT
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Zip | 06013-1828
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Country | US
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Telephone | 860-805-5830
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3563
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License Number State | CT
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