Healthcare Provider Details

I. General information

NPI: 1528468378
Provider Name (Legal Business Name): JEANNE FRANCIS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2014
Last Update Date: 08/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 HAYNES ST
MANCHESTER CT
06040-4131
US

IV. Provider business mailing address

41 SNIPSIC LAKE RD
ELLINGTON CT
06029-3521
US

V. Phone/Fax

Practice location:
  • Phone: 860-533-3434
  • Fax:
Mailing address:
  • Phone: 860-533-3434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number344
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: