Individual
MS. IDENA MAYNARD-EPPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
24 MIRANDA LN, STRATFORD, CT 06615-5770
(917) 890-7712
Mailing address
24 MIRANDA LN, STRATFORD, CT 06615-5770
(917) 890-7712
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
012274
CT
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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