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Individual

MR. JASON ELIJAH SPANN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
1057 BROAD ST FL 3, BRIDGEPORT, CT 06604-4219
(203) 996-2661
(203) 336-6525
Mailing address
PO BOX 84, BRIDGEPORT, CT 06601-0084
(203) 996-2661
(203) 336-6525

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7106
CT

Other

Enumeration date
09/08/2009
Last updated
03/17/2018
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