Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 006909 | CT |
NPI | 1003198094 |
---|---|
Provider Name | Mrs. Sheila Ann Bridges-Howard |
First Address | East Hartford, CT 06118-1103 |
Second Address | East Hartford, CT 06118-1103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2011 |
Last Update Date | 05/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
008046009 | (05) | CT |