Individual
BARBARA J FASULO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2257 SILAS DEANE HWY, ROCKY HILL, CT 06067-2328
(860) 416-5288
Mailing address
59 CLUBHOUSE DR, CROMWELL, CT 06416-2565
(860) 416-5288
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11785
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11785
LCSW
CT
Enumeration date
09/04/2018
Last updated
11/04/2021
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