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Individual

GENESIS CAMPOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
71 RAYMOND RD, WEST HARTFORD, CT 06107-2211
(860) 335-8765
Mailing address
71 RAYMOND RD, WEST HARTFORD, CT 06107-2211
(860) 335-8765

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
5000
CT
1041C0700X
Clinical Social Worker
Primary
011494
CT

Other

Enumeration date
11/01/2020
Last updated
07/14/2021
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