Individual
JESSICA RESNICKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
71 HAYNES ST, MANCHESTER MEMORIAL HOSPITAL, MANCHESTER, CT 06040-4131
(860) 533-3494
(860) 647-6831
Mailing address
150 N. MAIN ST., SUITE 130, ECHN MEDICAL BUILDING, MANCHESTER, CT 06042-2086
(860) 533-3434
(860) 647-6829
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
006886
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004025177
—
CT
01
—
006886
CT LICENSE
CT
Enumeration date
10/24/2008
Last updated
12/05/2014
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