Most Relevant Information
Provider Data
| NPI Number: | 1003350877 |
| Provider Name: | JONATHAN CODRARO M.S |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/13/2016 |
| Last Updated: | 12/13/2016 |
Provider Practice Location
74 EAST ST
PLAINVILLE
CT
060622367
Practice Location Phone/Fax
| Phone: | 8604669646 |
| Fax: |
Provider Mailing Location
74 EAST ST
PLAINVILLE
CT
060622367
Provider Mailing Phone/Fax
| Phone: | 8604669646 |
| Fax: |