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NPI 1841836764

NPI 1841836764 : JEANNE RICE LCSW : BRISTOL, CT

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General NPI Number Information
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    NPI Number           |    1841836764
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    Entity Type          |    Individual 
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    Provider Name        |    JEANNE RICE LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/26/2019
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    Last Update Date     |    01/04/2022
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Provider Practice Location Address
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    Address Line         |    225 N MAIN ST STE 106 
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    City                 |    BRISTOL
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    State                |    CT
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    Zip                  |    06010-4993
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    Country              |    US
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    Telephone            |    888-793-3500
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    437 MOUNT SANFORD RD 
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    City                 |    CHESHIRE
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    State                |    CT
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    Zip                  |    06410-3532
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    Country              |    US
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    Telephone            |    203-927-1574
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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       |    011780
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    License Number State |    CT
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