Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 4955 | CT |
NPI | 1003458928 |
---|---|
Provider Name | Tiffany Ramos |
First Address | New Haven, CT 06519 |
Second Address | New Haven, CT 06519-1610 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2019 |
Last Update Date | 11/10/2019 |