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General NPI Number Information
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NPI Number | 1407537848
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Entity Type | Individual
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Provider Name | SHINEA GIRARD
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Gender | Female
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Dates
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Enumeration Date | 07/28/2023
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 660 PROSPECT AVE
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City | HARTFORD
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State | CT
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Zip | 06105-4230
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Country | US
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Telephone | 860-999-4431
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Fax |
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Provider Business Mailing Address
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Address Line | 55 SHERBROOKE AVE
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City | HARTFORD
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State | CT
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Zip | 06106-3839
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 7169
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License Number State | CT
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