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NPI 1174154314

NPI 1174154314 : JACQUELINE SAVO GUILIANO : NAUGATUCK, CT

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General NPI Number Information
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    NPI Number           |    1174154314
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    Entity Type          |    Individual 
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    Provider Name        |    JACQUELINE SAVO GUILIANO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/27/2020
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    Last Update Date     |    03/30/2023
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Provider Practice Location Address
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    Address Line         |    39 APPLEWOOD LN 
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    City                 |    NAUGATUCK
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    State                |    CT
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    Zip                  |    06770-3176
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    Country              |    US
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    Telephone            |    203-997-7782
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    39 APPLEWOOD LN 
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    City                 |    NAUGATUCK
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    State                |    CT
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    Zip                  |    06770-3176
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    Country              |    US
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    Telephone            |    203-997-7782
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    0904014510
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    License Number State |    VA
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Taxonomy #3
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    012422
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    License Number State |    CT
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