Graduated: 2008
NPI: 1730377417
Practice Locations (2)
STATE OF CONNECTICUT
1635 CENTRAL AVE
BRIDGEPORT, CT 066102717
2035517464
STATE OF CONNECTICUT
55 W MAIN ST, 410 WESTERN CONNECTICUT MENTAL HEALTH N
WATERBURY, CT 067025524
2038056414
Source: CMS National Downloadable File, September 2026.