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Organization
MOYOSORE PAUPAU, LLC
Active
Organization
MOYOSORE PAUPAU, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MOYSORE PAUPAU-MICKENS LCSW (OWNER)
(203) 496-2074
Entity
Organization
Contact information
Practice address
860 CANAL ST, STAMFORD, CT 06902-6953
(203) 496-2074
(203) 355-2667
Mailing address
39 GLENBROOK RD, 5Z, STAMFORD, CT 06902-2968
(203) 496-2074
(203) 355-2667
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
006466
CT
Other
Enumeration date
04/28/2009
Last updated
04/28/2009
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