Individual
DORA L BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
30 SHELBURNE RD, STAMFORD, CT 06902-3628
(203) 276-7111
(203) 276-7081
Mailing address
30 SHELBURNE RD, STAMFORD, CT 06902-3628
(203) 276-7111
(203) 276-7081
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
003915
CT
Other
Enumeration date
08/29/2006
Last updated
07/13/2007
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