Individual
IVY ERAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
306 MERLINE RD, VERNON, CT 06066-4030
(860) 716-3667
Mailing address
306 MERLINE RD, VERNON, CT 06066-4030
(860) 716-3667
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8525
CT
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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