Individual
JESSICA BAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
54 NORTH ST, WILLIMANTIC, CT 06226-2528
(860) 450-7122
Mailing address
54 NORTH ST, WILLIMANTIC, CT 06226-2528
(860) 450-7122
(860) 450-7127
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10487
CT
1041C0700X
Clinical Social Worker
58.010487
CT
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
09/08/2015
Last updated
07/05/2022
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