Provider Information for 1912680414
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EDWARD D. PAQUETTE LPC
Sex: Male
NPI: 1912680414
Last Updated: 2024-01-09
Certification Date: 2024-01-09
Certification Date: 2024-01-09
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1912680414 | ||||||||
| Enumeration Date | 2023-08-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 58 LIGHTHOUSE HILL RD WINDSOR, CT 06095-1210 United States Phone: 860-818-8024 | Fax: | ||||||||
| Primary Practice Address | 58 LIGHTHOUSE HILL RD WINDSOR, CT 06095-1210 United States Phone: 860-818-8024 | Fax: | ||||||||
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