Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
N | 101YM0800X | Mental Health Counselor | 002233 | CT |
N | 101YP1600X | Pastoral Counselor | ||
Y | 101YP2500X | Professional Counselor | 002233 | CT |
NPI | 1104074178 |
---|---|
Provider Name | Ms. Lynnette Colon |
First Address | Manchester, CT 06040-3924 |
Second Address | Manchester, CT 06040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2008 |
Last Update Date | 03/06/2019 |