Marissa Lynn Stafford, LMSW
Social Worker, Clinical in Weatogue, CT. Individual provider (NPI-1).
NPI number1730451683
StatusActive
Last updated in NPPESMar 11, 2016
Details
- NPI
- 1730451683
- Entity type
- Individual (NPI-1)
- Name
- Marissa Lynn Stafford
- Credential
- LMSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 7, 2012
- Last updated
- Mar 11, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
Practice location
121 Old Canal WayWeatogue, CT 06089-9688
Phone 860-866-7687
Mailing address
121 Old Canal WayWeatogue, CT 06089-9688
Phone 860-866-7687
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