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General NPI Number Information
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NPI Number | 1730627886
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Entity Type | Organization
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Legal Business Name | AMANDA SIRIGNANO
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Dates
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Enumeration Date | 02/09/2017
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Last Update Date | 02/09/2017
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Provider Practice Location Address
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Address Line | 2475 ALBANY AVE
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City | WEST HARTFORD
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State | CT
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Zip | 06117-2520
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Country | US
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Telephone | 203-525-5270
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Fax |
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Provider Business Mailing Address
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Address Line | 319 THOMASTON RD UNIT 63
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City | WATERTOWN
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State | CT
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Zip | 06795-2058
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Country | US
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Telephone | 203-525-5270
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA L SIRIGNANO
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Credential | LCSW
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Telephone | 203-525-5270
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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 | 7681
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License Number State | CT
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