Individual
COLLETTE WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1251 S MAIN ST, MIDDLETOWN, CT 06457-5050
(860) 346-0771
(860) 346-0772
Mailing address
1251 S MAIN ST, MIDDLETOWN, CT 06457-5050
(860) 346-0771
(860) 346-0772
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1931
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1931
LMSW
CT
Enumeration date
07/22/2015
Last updated
07/22/2015
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