Provider Information for 1215463419
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Ms. LIDIA VITTORIA VERDURA LCSW
Sex: Female
NPI: 1215463419
Last Updated: 2017-05-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1215463419 | ||||||||||||
| Enumeration Date | 2017-05-08 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 718 BUNKER HILL AVE WATERBURY, CT 06708-1803 United States Phone: 203-232-9705 | Fax: | ||||||||||||
| Primary Practice Address | 301 HIGHLAND AVENUE WATERBURY, CT 06708-1803 United States Phone: 203-232-9705 | Fax: | ||||||||||||
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