Basic Information
| Provider Information | |||||||||
| NPI: | 1073623997 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRATT | ||||||||
| FirstName: | PAMELA | ||||||||
| MiddleName: | H. | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 56 FRANKLIN ST | ||||||||
| Address2: | |||||||||
| City: | WATERBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 067061253 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037098888 | ||||||||
| FaxNumber: | 2037097247 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 JEFFERSON SQ | ||||||||
| Address2: | |||||||||
| City: | WATERBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 067061109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037093321 | ||||||||
| FaxNumber: | 2037093335 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 10/19/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 004405 | CT | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.