Individual
BIANCA ISABEL SHASTOKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
446A BLAKE ST, NEW HAVEN, CT 06515-4437
(475) 434-6077
Mailing address
446A BLAKE ST, NEW HAVEN, CT 06515-4437
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8148
CT
Other
Enumeration date
09/15/2023
Last updated
09/15/2023
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