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1154808855
DOMINIQUE SHABAZZ
HARTFORD, CT
NPI
1154808855
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CT 101973)
Enumeration Date
2018-07-25
Last Update Date
2018-07-25
Business Address
DOMINIQUE SHABAZZ
660 PROSPECT AVE
HARTFORD, CT 06105-4230
Phone number: 860-778-0266
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Mailing Address
DOMINIQUE SHABAZZ
40 COURT ST
WINDSOR, CT 06095-2909
Phone number:
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