Individual
DEBBIE N DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
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
Update your record
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