Individual
AMANDA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
60 EDMUND STREET, STRATFORD, CT 06614
(203) 449-3203
Mailing address
60 EDMUND ST, STRATFORD, CT 06614-4839
(203) 449-3203
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3810
CT
Other
Enumeration date
07/03/2017
Last updated
07/21/2022
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