| Doctor Name: | SANDRA GONSALVES |
| NPI Number: | 1033228176 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 005483 |
| Business Practice Address: | 300 Church St Suite 202 Yalesville, CT - 064922253 |
| Business Phone Number: | 2032657770 |
| Business Fax Number: | 2032940536 |
| Mailing Address: | 1381 Rhey Ave, WALLINGFORD |
| State: | CT |
| Postal Code: | 064923314 |
| Phone Number: | 2032657562 |
| Fax Number: | 2032940536 |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 005483 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |