Healthcare Provider Details

I. General information

NPI: 1245322767
Provider Name (Legal Business Name): DONNA FRANCES LOISELLE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 FRANKLIN SQ
NEW BRITAIN CT
06051-2607
US

IV. Provider business mailing address

90 FRANKLIN SQ
NEW BRITAIN CT
06051-2607
US

V. Phone/Fax

Practice location:
  • Phone: 860-225-3561
  • Fax: 860-225-2558
Mailing address:
  • Phone: 860-225-3561
  • Fax: 860-225-2558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number000583
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: