| Latanya Bizor, Lcsw,llc | |
|
969 W Main St Ste 2g Waterbury CT 06708-2653 | |
| (475) 275-8245 | |
| Not Available |
| Full Name | Latanya Bizor, Lcsw,llc |
|---|---|
| Speciality | Social Worker |
| Location | 969 W Main St, Waterbury, Connecticut |
| Authorized Official Name and Position | Latanya D. Bizor (OWNER) |
| Authorized Official Contact | 2032149437 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Latanya Bizor, Lcsw,llc 969 W Main St Ste 2g Waterbury CT 06708-2653 Ph: (475) 275-8245 | Latanya Bizor, Lcsw,llc 969 W Main St Ste 2g Waterbury CT 06708-2653 Ph: (475) 275-8245 |
| NPI Number | 1265972681 |
|---|---|
| Provider Enumeration Date | 03/04/2017 |
| Last Update Date | 03/04/2017 |
| Medicare PECOS PAC ID | 0840577433 |
|---|---|
| Medicare Enrollment ID | O20170509001085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265972681 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 009303 (Connecticut) | Primary |
| Provider Name | Latanya D Bizor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770824757 PECOS PAC ID: 7517242043 Enrollment ID: I20170509001263 |
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