Individual
WANDA D JOFRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
34 PARK ST RM 162, CONNECTICUT MENTAL HEALTH CENTER, NEW HAVEN, CT 06519-1109
(203) 974-7632
Mailing address
34 PARK ST RM 162, CONNECTICUT MENTAL HEALTH CENTER, NEW HAVEN, CT 06519-1109
(203) 974-7632
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004212148
—
CT
01
—
CTGA000525
DMHAS
CT
Enumeration date
10/21/2008
Last updated
04/21/2015
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