Individual
AMY JO PODGORSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
91 NORTHWEST DR, PLAINVILLE, CT 06062-1534
(860) 793-3849
Mailing address
2 WOODSIDE DR, UNIONVILLE, CT 06085-1549
(860) 404-0863
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
065
CT
Other
Enumeration date
02/12/2007
Last updated
07/08/2007
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