Individual
KEMPTON BRISPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
30 BUXTON FARM RD, STAMFORD, CT 06905-1224
(203) 212-4191
Mailing address
30 BUXTON FARM RD, STAMFORD, CT 06905-1224
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
821
CT
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/27/2018
Last updated
04/09/2018
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