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Individual

CORINA JANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
18 WITHEY HILL RD, MOOSUP, CT 06354-1316
(860) 886-0567
Mailing address
18 WITHEY HILL RD, MOOSUP, CT 06354-1316
(860) 972-6970

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8582
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
58008582
CT DPH
CT
Enumeration date
03/27/2012
Last updated
04/21/2022
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