Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003112749 |
---|---|
Provider Name | Ms. Indre Jarmusyte |
First Address | Kensington, CT 06037-1831 |
Second Address | Plainville, CT 06062-1534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2011 |
Last Update Date | 27/01/2011 |