Individual
MRS. JO ANNE NANCY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
883 BLACK ROCK TPKE, FAIRFIELD, CT 06825-2729
(203) 243-8796
Mailing address
883 BLACK ROCK TPKE, FAIRFIELD, CT 06825-2729
(203) 243-8796
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
002809
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180231
MHN
—
01
—
336637
HEALTHNET
—
01
—
6239332
UNITED HEALTH
—
Enumeration date
09/29/2006
Last updated
07/08/2007
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