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1528582830
TYLICE C MACDONALD
BRIDGEPORT, CT
NPI
1528582830
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2017-07-28
Last Update Date
2022-07-21
Business Address
TYLICE C MACDONALD
170 BENNETT STREET
BRIDGEPORT, CT 06605
Phone number: 203-330-6790
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Mailing Address
TYLICE C MACDONALD
170 BENNETT ST
BRIDGEPORT, CT 06605-2901
Phone number: 203-330-6790
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