Individual
MARA E RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1046 FAIRFIELD AVE, BRIDGEPORT, CT 06605-1116
(203) 330-6000
Mailing address
1323 STRATFORD AVE APT 4, BRIDGEPORT, CT 06607-1431
(203) 556-0435
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4876
CT
Other
Enumeration date
11/04/2019
Last updated
11/04/2019
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