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General NPI Number Information
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NPI Number | 1710062435
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Entity Type | Individual
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Provider Name | JILL ELLIOTT HOLMGREN MSW
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Gender | Female
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7 VAUXHALL STREET
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City | NEW LONDON
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State | CT
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Zip | 06320
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Country | US
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Telephone | 860-442-2797
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Fax | 860-701-3776
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Provider Business Mailing Address
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Address Line | 66 WASHINGTON AVENUE
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City | EAST HARTFORD
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State | CT
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Zip | 06118
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Country | US
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Telephone | 860-519-1943
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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 |
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License Number State |
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