Provider Demographics
NPI:1750707808
Name:MARRIOTT, OLUWATOSIN (LPC)
Entity type:Individual
Prefix:
First Name:OLUWATOSIN
Middle Name:
Last Name:MARRIOTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1447 NEW LITCHFIELD ST
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-6021
Mailing Address - Country:US
Mailing Address - Phone:203-551-4947
Mailing Address - Fax:203-549-0503
Practice Address - Street 1:1447 NEW LITCHFIELD ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-6021
Practice Address - Country:US
Practice Address - Phone:203-551-4947
Practice Address - Fax:203-549-0503
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-13
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002278101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health