Organization
COMMUNITY RENEWAL TEAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY ALONZO WATTS LCSW (CLINICIAN)
(860) 951-8770
Entity
Organization
Contact information
Practice address
1921 PARK ST, HARTFORD, CT 06106-2118
(860) 951-8770
(860) 233-2796
Mailing address
1921 PARK ST, HARTFORD, CT 06106-2118
(860) 951-8770
(860) 233-2796
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
007737
CT
Other
Enumeration date
12/14/2011
Last updated
12/14/2011
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