Individual
JIRINA ANN FARGEORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
60 CONNOLLY PKWY BLDG 2B, HAMDEN, CT 06514-2593
(203) 909-6705
(475) 238-6355
Mailing address
60 CONNOLLY PKWY BLDG 2B, HAMDEN, CT 06514-2593
(203) 909-6705
(475) 238-6355
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10066
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
800424787
—
CT
Enumeration date
12/02/2024
Last updated
12/02/2024
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