Dominique Moss, LMSW
Social Worker in Waterbury, CT. Individual provider (NPI-1).
NPI number1114508314
StatusActive
Last updated in NPPESApr 19, 2021
Details
- NPI
- 1114508314
- Entity type
- Individual (NPI-1)
- Name
- Dominique Moss
- Credential
- LMSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 19, 2021
- Certification date
- Apr 19, 2021
- Last updated
- Apr 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 104100000X | Social Worker | 130506001 | CT | Yes |
Practice location
855 Lakewood RdWaterbury, CT 06704-5408
Phone 203-695-7691
Mailing address
855 Lakewood RdWaterbury, CT 06704-5408
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