Organization
JENIFER L GIETEK LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENIFER LEE GIETEK LCSW (OWNER)
(860) 508-6633
Entity
Organization
Contact information
Practice address
891 MAIN STREET, 2ND FLOOR OFFICE D, SOUTH GLASTONBURY, CT 06073
(860) 508-6633
Mailing address
PO BOX 128, TOLLAND, CT 06084-0128
(860) 508-6633
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
008070
CT
Other
Enumeration date
03/19/2014
Last updated
03/19/2014
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