Individual
DOMINIQUE DECILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
67 TRUMBULL ST, NEW HAVEN, CT 06510-1004
(203) 710-6339
Mailing address
109 LEGION AVE, NEW HAVEN, CT 06519-5506
(203) 562-2264
(203) 401-2040
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9304
CT
Other
Enumeration date
12/10/2015
Last updated
10/25/2018
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