Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 000552 | CT |
NPI | 1003907403 |
---|---|
Provider Name | Ms. Sharon M Fornaciari |
First Address | Stamford, CT 06905 |
Second Address | Stamford, CT 06905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |