MISS Mya Petchark, LADC
NPI #1144069840 in New London, Connecticut
Provider Information
- NPI Number
- 1144069840
- Entity Type
- Individual
- Name
- MISS Mya Petchark, LADC
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Credential
- LADC
- Enumeration Date
- May 22, 2024
- Last Updated
- May 22, 2024
Practice Location
- Address
- 931 BANK ST
- City
- New London
- State
- Connecticut
- ZIP Code
- 06320-2702
- Phone
- (860) 574-8252
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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