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General NPI Number Information
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NPI Number | 1619758752
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Entity Type | Individual
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Provider Name | ALIA BAREFOOT
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Gender | Female
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 56 ABNER LN
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City | KILLINGWORTH
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State | CT
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Zip | 06419-1153
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Country | US
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Telephone | 860-663-3036
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Fax |
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Provider Business Mailing Address
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Address Line | 56 ABNER LN
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City | KILLINGWORTH
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State | CT
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Zip | 06419-1153
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Country | US
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Telephone | 203-350-9798
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 58.012662
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License Number State | CT
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