Individual
JENNIFER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
38 EGAN RD, MIDDLETOWN, CT 06457-3043
(860) 344-8094
Mailing address
38 EGAN RD, MIDDLETOWN, CT 06457-3043
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
007708
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007708
LCSW
CT
Enumeration date
03/09/2012
Last updated
03/09/2012
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