Individual
JACOB JAMES CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
77 CHARTER RD, WETHERSFIELD, CT 06109-4307
(802) 380-9473
Mailing address
77 CHARTER RD, WETHERSFIELD, CT 06109-4307
(802) 380-9473
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14499
CT
Other
Enumeration date
07/18/2022
Last updated
10/02/2024
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