Individual
JYLL ROBIN HERZOG SOUTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
305 BOSTON AVE, STRATFORD, CT 06614-5246
(203) 384-3377
(203) 378-8578
Mailing address
305 BOSTON AVE, STRATFORD, CT 06614-5246
(203) 384-3377
(203) 378-8578
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
104100000X-SOCIAL WO
CT
Other
Enumeration date
07/28/2006
Last updated
07/08/2007
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