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General NPI Number Information
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NPI Number | 1548339336
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Entity Type | Individual
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Provider Name | REBECCA SUZZANNE GAFFRON LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 08/10/2007
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Provider Practice Location Address
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Address Line | 115 ELM ST SUITE 103
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City | ENFIELD
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State | CT
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Zip | 06082-3712
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Country | US
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Telephone | 860-808-6241
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Fax | 860-253-0079
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Provider Business Mailing Address
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Address Line | 12 DEPONTE DR
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City | LUDLOW
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State | MA
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Zip | 01056-1538
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Country | US
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Telephone | 860-808-6241
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Fax | 860-253-0079
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 006115
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License Number State | CT
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