Individual
JESSICA H CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
675 TOWER AVE, SUITE 301, HARTFORD, CT 06112-1273
(860) 714-2750
(860) 714-8591
Mailing address
675 TOWER AVE, SUITE 301, HARTFORD, CT 06112-1273
(860) 714-2750
(860) 714-8591
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
006694
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
CT
Enumeration date
05/08/2009
Last updated
06/10/2009
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