Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 002152 | CT |
NPI | 1003030321 |
---|---|
Provider Name | Ms. Teresa Perrucci |
First Address | Southbury, CT 06488-2288 |
Second Address | Torrington, CT 06790-4643 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 25/01/2016 |