Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 454 | CT |
NPI | 1003189788 |
---|---|
Provider Name | Allison Bassett |
First Address | New Haven, CT 06511-4620 |
Second Address | New Haven, CT 06510-2069 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2012 |
Last Update Date | 03/10/2014 |