Healthcare Provider Details

I. General information

NPI: 1265766950
Provider Name (Legal Business Name): ALISON E. THURBER M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 08/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 THORNTON STREET
HAMDEN CT
06517
US

IV. Provider business mailing address

1 BRADLEY ROAD SUITE 905
WOODBRIDGE CT
06525
US

V. Phone/Fax

Practice location:
  • Phone: 203-691-6811
  • Fax:
Mailing address:
  • Phone: 203-298-9005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number007010
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: