Individual
MRS. KRISTI LOUISE IVEZAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2960 POST RD FL 3, SOUTHPORT, CT 06890-1268
(203) 307-3030
Mailing address
63 FITCH LN, NEW CANAAN, CT 06840-5052
(706) 761-3998
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5253
CT
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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