Individual
KIMONA SHATICE SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-9704
Mailing address
600 CLARK AVE APT 36, BRISTOL, CT 06010-4098
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
010026
CT
Other
Enumeration date
05/14/2014
Last updated
01/02/2019
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