Individual
HEATHER LYN ROSENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
201 HULLS HWY, SOUTHPORT, CT 06890-1183
(203) 640-0777
Mailing address
201 HULLS HWY, SOUTHPORT, CT 06890-1183
(203) 640-0777
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
010177
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010177
LICENSED CLINICAL SOCIAL WORKER
CT
Enumeration date
04/21/2022
Last updated
04/21/2022
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