Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | 052957 | NY |
Y | 1041C0700X | Clinical Social Worker | 005278 | CT |
NPI | 1003248956 |
---|---|
Provider Name | Ms. Alison Marie Luciano |
First Address | Wolcott, CT 06716-2766 |
Second Address | Woodbury, CT 06798-3651 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2013 |
Last Update Date | 02/08/2013 |