Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 009624 | CT |
N | 103TF0000X | Family Psychologist | 009624 | CT |
N | 103TP2701X | Group Psychotherapist | 009624 | CT |
Y | 1041C0700X | Clinical Social Worker | 009624 | CT |
NPI | 1144566597 |
---|---|
Provider Name | Amneris Jenice Torres |
First Address | Hartford, CT 06106-3322 |
Second Address | West Hartford, CT 06110-2447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2012 |
Last Update Date | 17/03/2018 |