Individual
WEETHNE DORVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
170 BENNETT ST, BRIDGEPORT, CT 06605-2901
(203) 330-6790
Mailing address
170 BENNETT ST, BRIDGEPORT, CT 06605-2901
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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