Individual
JENNIFER ROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
139 HAZARD AVE, BUILDING 2/UNIT 8, ENFIELD, CT 06082-4585
(860) 933-7311
Mailing address
4074 MOUNTAIN RD, WEST SUFFIELD, CT 06093-2118
(860) 604-5777
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
008779
CT
Other
Enumeration date
06/05/2015
Last updated
06/05/2015
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