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General NPI Number Information
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NPI Number | 1295289627
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Entity Type | Individual
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Provider Name | JENNIFER PASKIEWICZ VONDLE M.S., LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/15/2016
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 50 BROAD ST UNIT 29
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City | MILFORD
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State | CT
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Zip | 06460-4700
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Country | US
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Telephone | 203-823-6313
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Fax | 833-254-1975
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Provider Business Mailing Address
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Address Line | 19 ELGIN RD
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City | MILFORD
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State | CT
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Zip | 06460-3717
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Country | US
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Telephone | 203-823-6313
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 002027
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License Number State | CT
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