Individual
AGNES BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
500 VINE ST, CAPITOL REGION MENTAL HEALTH CENTER, HARTFORD, CT 06114
(860) 297-0905
(860) 297-0931
Mailing address
500 VINE STREET, HUMAN RESOURCE, HARTFORD, CT 06114
(860) 297-0905
(860) 297-0931
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
231744423
CT
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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