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ALEXANDRIA BLAUROCK

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1164000188

Individual Registrant:
 ALEXANDRIA  BLAUROCK 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
555 HIGHLAND AVE  CHESHIRE, CT 06410-2255 US
Tel: 860-385-1472  Fax: --

Contact information for business:
75 HOCKANUM BLVD UNIT 2935  VERNON, CT 06066-4077 US
Tel: 913-219-6411  Fax: --

Registration Information:
NPI: 1164000188
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health
CT4578

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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