Individual
ISOKEN IYAMU-OSAGIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
200 RETREAT AVENUE, HARTFORD HOSPITAL PSYCHIATRY DEPT, HARTFORD, CT 06106-3309
(860) 545-7200
Mailing address
200 RETREAT AVENUE, HARTFORD HOSPITAL PSYCHIATRY DEPT, HARTFORD, CT 06106-3309
(860) 545-7200
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
009241
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386089548
—
CT
Enumeration date
05/01/2013
Last updated
06/18/2020
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