Provider Demographics
NPI:1124405832
Name:MARRO, ALICIA (MFT)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:MARRO
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:CONDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:134 STATE STREET
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-3293
Mailing Address - Country:US
Mailing Address - Phone:203-237-2229
Mailing Address - Fax:
Practice Address - Street 1:134 STATE STREET
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-3293
Practice Address - Country:US
Practice Address - Phone:203-237-2229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-01
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1870106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist