Individual
MRS. DEANNA HALE PICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004642
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004239986
—
CT
01
—
140004642CT01
ANTHEM BC/BS
CT
01
—
300121
MANAGED HEALTH NETWORK
CT
01
—
511750
VALUE OPTIONS
CT
01
—
7675564
AETNA
TX
01
—
P2943998
OXFORD HEALTH PLANS
CT
Enumeration date
07/23/2006
Last updated
06/01/2018
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