Individual
IVELISE ALICEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
46 ALBION ST, BRIDGEPORT, CT 06605-2602
(203) 330-6000
(203) 339-7193
Mailing address
46 ALBION ST, BRIDGEPORT, CT 06605-2602
(203) 330-6000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
010440
CT
Other
Enumeration date
12/04/2013
Last updated
12/30/2019
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