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General NPI Number Information
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NPI Number | 1740662345
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Entity Type | Organization
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Legal Business Name | YASMINE SASANNEJAD
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Dates
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Enumeration Date | 06/19/2015
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Last Update Date | 06/19/2015
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Provider Practice Location Address
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Address Line | 49 CHURCH ST
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City | NORWICH
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State | CT
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Zip | 06360-5001
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Country | US
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Telephone | 845-820-0342
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 549
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City | VOLUNTOWN
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State | CT
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Zip | 06384-0549
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | YASMINE SASANNEJAD
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Credential |
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Telephone | 845-820-0342
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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 | 2781
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License Number State | CT
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