Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 58.009882 | CT |
NPI | 1003199985 |
---|---|
Provider Name | Corey G Toby |
First Address | Stamford, CT 06902-5883 |
Second Address | Westport, CT 06880-4626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2011 |
Last Update Date | 14/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
008074755 | (05) | CT |