Individual
DIANE K VIVEIROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW (LCSW/LICSW)
Contact information
Practice address
184 LIBERTY ST, LV110, NEW HAVEN, CT 06519-1625
(203) 688-9926
Mailing address
77 HILLCREST RD, GLASTONBURY, CT 06033-3101
(203) 688-9754
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004489
CT
1041C0700X
Clinical Social Worker
1019597
MA
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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