Individual
CARYN ELIZABETH GANUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
51 BROAD ST, MIDDLETOWN, CT 06457-3204
(860) 358-3401
(860) 358-3403
Mailing address
51 BROAD ST, MIDDLETOWN, CT 06457-3204
(860) 358-3401
(860) 358-3403
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
007011
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007011
LIC #
CT
Enumeration date
11/15/2012
Last updated
11/15/2012
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