Individual
JENNIFER AYERS FORMOSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
55 BONNIE VIEW DR, TRUMBULL, CT 06611-4701
(203) 520-3114
Mailing address
55 BONNIE VIEW DR, TRUMBULL, CT 06611-4701
(203) 520-3114
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004638
CT
Other
Enumeration date
08/08/2007
Last updated
08/08/2007
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