Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 003457 | CT |
NPI | 1003089467 |
---|---|
Provider Name | Patricia A Colella |
First Address | Old Saybrook, CT 06475-4214 |
Second Address | Old Saybrook, CT 06475-4214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2008 |
Last Update Date | 08/04/2008 |