Individual
JESSICA LAUREN VIVENZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9 MOTT AVE FL 4, NORWALK, CT 06850-3330
(203) 523-5793
Mailing address
9 MOTT AVE FL 4, NORWALK, CT 06850-3330
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10945
CT
Other
Enumeration date
02/11/2020
Last updated
02/11/2020
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