Doctor Name: | PATRICIA TARDIF |
NPI Number: | 1861896193 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 006867 |
Business Practice Address: | 861 S Main St #28 Plantsville, CT - 064791533 |
Business Phone Number: | 8603094212 |
Business Fax Number: | |
Mailing Address: | 861 S Main St, #28 PLANTSVILLE |
State: | CT |
Postal Code: | 064791533 |
Phone Number: | 8603094212 |
Fax Number: | |
NPI Enumeration Date: | 10/15/2014 |
NPI Last Update Date: | 10/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 006867 |
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 |