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Individual

DEBBIE N DOUGLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
130 DIVISION STREET, GRIFFIN HOSPITAL, DERBY, CT 06418
(203) 732-7550
(203) 732-1550
Mailing address
130 DIVISION STREET, GRIFFIN HOSPITAL, DERBY, CT 06418
(203) 732-7550
(203) 732-1550

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
005804
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
005804
STATE LICENCE
CT
Enumeration date
06/11/2008
Last updated
06/11/2008
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