Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1096576 | CT |
N | 1041C0700X | Clinical Social Worker | 006375 | CT |
NPI | 1013264712 |
---|---|
Provider Name | Mrs. Adrianna Olga Zambrzycka-Broomhead |
First Address | Glastonbury, CT 06033-2218 |
Second Address | Glastonbury, CT 06033-2218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2012 |
Last Update Date | 17/12/2019 |