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Individual

DOREEN E BUTTNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
10 N MAIN ST, SUITE 210, BRISTOL, CT 06010-8122
(860) 314-2052
(860) 314-2054
Mailing address
PO BOX 2828, BRISTOL, CT 06011-2828
(860) 585-3906
(860) 585-3907

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
1754
CT
1041C0700X
Clinical Social Worker
Primary
001754
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004196011
CT
Enumeration date
12/12/2005
Last updated
09/16/2013
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