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Cassandra Charles-tabacco
Professional Counselor in Bridgeport, Connecticut
NPI 1811417082

Cassandra Charles-tabacco is a Professional Counselor based in Bridgeport, CT and is specialized in Professional. Cassandra Charles-tabacco practices in Bridgeport, CT. The NPI Number for Cassandra Charles-tabacco is 1811417082 and holds a License No. (Connecticut).

The current practice location address for Cassandra Charles-tabacco is 180 Fairfield Ave, Bridgeport, CT and can be reached out via phone at 203-394-6529 and via fax at 203-610-6131.

Location: 180 Fairfield Ave, Bridgeport, CT, 06604-4252
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811417082
Provider Name
Cassandra Charles-tabacco
Credential
Provider Entity Type
Individual
Gender
Female
Address
180 Fairfield Ave, Bridgeport, CT, 06604-4252
Phone Number
203-394-6529
Fax Number
203-610-6131
Provider Enumeration Date
06/20/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
06-0669106 05 CT
institution
Provider Business Practice Location Address Details
Address
180 Fairfield Ave
City
Bridgeport
State
Connecticut
Zip
06604-4252
Phone Number
203-394-6529
Fax Number
203-610-6131
person
Provider Business Mailing Address Details
Address
180 Fairfield Ave
City
Bridgeport
State
Connecticut
Zip
06604-4252
Phone Number
203-394-6529
Fax Number
203-610-6131
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
(Connecticut)
Definition
Definition to come...
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