Healthcare Provider Details

I. General information

NPI: 1023402641
Provider Name (Legal Business Name): GEORGE OTU-APPIAH LMSW,MSW,BS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2015
Last Update Date: 07/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 COLT HWY
FARMINGTON CT
06032-3076
US

IV. Provider business mailing address

306 COLT HWY
FARMINGTON CT
06032-3076
US

V. Phone/Fax

Practice location:
  • Phone: 860-838-1738
  • Fax:
Mailing address:
  • Phone: 860-838-1738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1002
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: