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1205019569
EDGAR JIMENEZ
WATERBURY, CT
NPI
1205019569
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CT CADC1378)
Enumeration Date
2007-12-10
Last Update Date
2007-12-10
Business Address
Mr. EDGAR JIMENEZ Cadc
402 E MAIN ST
WATERBURY, CT 06702-1701
Phone number: 023-755-1143
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Mailing Address
Mr. EDGAR JIMENEZ Cadc
402 E MAIN ST
WATERBURY, CT 06702-1701
Phone number: 023-755-1143
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