Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 003337 | CT |
NPI | 1003130519 |
---|---|
Provider Name | Ms. Suzanne A Rosenberg |
First Address | Southington, CT 06489-2460 |
Second Address | Bristol, CT 06010-7404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2010 |
Last Update Date | 11/02/2022 |