Individual
MRS. IVELISSE SOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
95 THOMASTON AVE, WATERBURY, CT 06702-1007
(203) 805-5378
Mailing address
95 THOMASTON AVE, WATERBURY, CT 06702-1007
(203) 805-5378
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
006400
CT
Other
Enumeration date
04/03/2007
Last updated
02/16/2012
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