Individual
JULIAN STAKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 CONN BLVD FL 4, EAST HARTFORD, CT 06108-3239
(860) 569-5900
Mailing address
19 HIGHWOOD CIR, COLCHESTER, CT 06415-1283
(860) 942-0735
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6736
CT
Other
Enumeration date
04/04/2023
Last updated
04/06/2023
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