Individual
RICARDO A DESOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
402 E MAIN ST, WATERBURY OP BEHAVIORAL HEALTH SERVICES IVP FAMILY, WATERBURY, CT 06702-1701
(203) 755-1143
(203) 753-3274
Mailing address
141 E MAIN ST, 4TH FLR ADMINISTRATION, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/04/2016
Last updated
08/04/2016
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