MEDICARE: RENE DROZDZIEL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	001995	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001995	OTHER	CT	LICENSE

General Provider Information

NPI Number	:	1265971964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENE DROZDZIEL

Provider Business Mailing Address
First Line	:	21 CRESTVIEW RD
Second Line	:
City	:	TERRYVILLE
State	:	CT
Zip	:	06786-4429
Country	:	US
Telephone Number	:	860-681-8415
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 S MAIN ST STE 202
Second Line	:
City	:	THOMASTON
State	:	CT
Zip	:	06787-1741
Country	:	US
Telephone Number	:	860-681-8415
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2017
Last Update Date	:	08/08/2024

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Directions to “ RENE DROZDZIEL ” Practice Location

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