Individual
ERICA MOURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
200 RETREAT AVE, HARTFORD, CT 06106-3309
(860) 545-7200
(860) 545-7049
Mailing address
200 RETREAT AVE, HARTFORD, CT 06106-3309
(860) 545-7200
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
006267
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004249654
—
CT
01
—
1215979810
FACILITY NPI NUMBER
CT
Enumeration date
07/16/2006
Last updated
06/13/2016
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