Basic Information
| Provider Information | |||||||||
| NPI: | 1770691578 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BADIOLA | ||||||||
| FirstName: | VERONICA | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | HARTFORD HOSPITAL PROFESSIONAL SERVICES | ||||||||
| Address2: | PO BOX 40000 DEPT 634 | ||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061510634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8605457602 | ||||||||
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| Practice Location | |||||||||
| Address1: | 200 RETREAT AVE | ||||||||
| Address2: | HARTFORD HOSPITAL PSYCHIATRY DEPARTMENT | ||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8605457330 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2006 | ||||||||
| LastUpdateDate: | 06/30/2009 | ||||||||
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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 | 005937 | CT | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.