Individual
JENNIFER REBECCA BRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
147 DURHAM RD, SUITE 1, MADISON, CT 06443-2675
(203) 804-5218
Mailing address
5002 DURHAM RD, GUILFORD, CT 06437-3610
(203) 804-5218
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
009092
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009092
LCSW LIC #
CT
Enumeration date
10/23/2015
Last updated
02/24/2016
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