Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 001334 | CT |
NPI | 1003076506 |
---|---|
Provider Name | Ms. Marie J. Morris |
First Address | New Haven, CT 06511-3708 |
Second Address | New Haven, CT 06511-3708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2008 |
Last Update Date | 10/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001334 | LCSW (01) | CT |