Most Relevant Information
Provider Data
| NPI Number: | 1003359761 |
| Provider Name: | PATRICE ANTHIA MOULTON LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/29/2016 |
| Last Updated: | 12/12/2019 |
Provider Practice Location
3 NORTHWESTERN DR
BLOOMFIELD
CT
060023465
Practice Location Phone/Fax
| Phone: | 8602433477 |
| Fax: | 8602433224 |
Provider Mailing Location
38 BENNETT CIR
HARTFORD
CT
061201153
Provider Mailing Phone/Fax
| Phone: | 8609850284 |
| Fax: |