Individual
IRMA I SANTIAGO MOIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1200 HIGH RIDGE RD STE 2, STAMFORD, CT 06905-1202
(203) 964-7941
Mailing address
50 HURD AVE, STRATFORD, CT 06614-5017
(203) 964-7941
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6871
CT
Other
Enumeration date
12/02/2008
Last updated
03/02/2023
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