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1174961437
VIRGINIA TAVERNER
NEW HAVEN, CT
NPI
1174961437
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CT 000988)
Enumeration Date
2013-06-10
Last Update Date
2017-10-02
Business Address
Ms. VIRGINIA TAVERNER LADC
54 E RAMSDELL ST
NEW HAVEN, CT 06515-1140
Phone number: 203-337-9943
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Mailing Address
Ms. VIRGINIA TAVERNER LADC
1 LONG WHARF DR
NEW HAVEN, CT 06511-5991
Phone number: 203-781-4600
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