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Individual

MISS TANISHA SONJIA BUNDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
191 WHALLEY AVE APT 158, NEW HAVEN, CT 06511-3220
(203) 214-6409
Mailing address
191 WHALLEY AVE APT 158 NEW HAVEN, NEW HAVEN, CT 06511
(203) 214-6409

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CT

Other

Enumeration date
11/04/2011
Last updated
11/04/2011
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