Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 000147 | CT |
NPI | 1003275934 |
---|---|
Provider Name | Mrs. Carrie L Amos |
First Address | New Fairfield, CT 06812-4816 |
Second Address | New Fairfield, CT 06812-4816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2016 |
Last Update Date | 20/02/2016 |