Individual
DOMINIQUE SHABAZZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
660 PROSPECT AVE, HARTFORD, CT 06105-4230
(860) 778-0266
Mailing address
40 COURT ST, WINDSOR, CT 06095-2909
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
101973
CT
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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