Individual
BRENDA MATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
42 BUCKLEY AVE, BRISTOL, CT 06010-6701
(860) 370-0373
Mailing address
42 BUCKLEY AVE, BRISTOL, CT 06010-6701
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9355
CT
Other
Enumeration date
03/20/2024
Last updated
03/20/2024
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