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Individual

ASHLEY SHATTUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
676 HEBRON AVE STE 1, GLASTONBURY, CT 06033-2410
(860) 692-2250
Mailing address
1290 SILAS DEANE HWY, HHC CVO ENROLLMENT, WETHERSFIELD, CT 06109-4337

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10736
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10736
CT LICENSE
CT
Enumeration date
11/19/2010
Last updated
09/20/2019
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