Individual
AUTUMN CLOUD-INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
932 LITCHFIELD TPKE, BETHANY, CT 06524-3019
(203) 390-0070
Mailing address
932 LITCHFIELD TPKE, BETHANY, CT 06524-3019
(203) 390-0070
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11955
CT
Other
Enumeration date
12/29/2021
Last updated
12/29/2021
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