MYA PETCHARK

NEW LONDON, CT
NPI1144069840
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CT  1565)
Enumeration Date2024-05-22
Last Update Date2024-05-22
Business Address
Miss MYA PETCHARK LADC
931 BANK ST
NEW LONDON, CT 06320-2702
Phone number: 860-574-8252
Mailing Address
Miss MYA PETCHARK LADC
359 LONG HILL RD APT 22
GROTON, CT 06340-3842
Phone number: 860-389-4630
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