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1053656777
ETHAN SANSOLO
CHESHIRE, CT
NPI
1053656777
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CT 58.008167)
Enumeration Date
2012-12-06
Last Update Date
2012-12-06
Business Address
-- ETHAN SANSOLO LCSW
407 HIGHLAND AVE, BUILDING A SUITE 6
CHESHIRE, CT 06410
Phone number: 860-335-7615
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Mailing Address
-- ETHAN SANSOLO LCSW
45 JIMMY LN
MERIDEN, CT 06450-7200
Phone number: 203-440-2351
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