Provider Demographics
NPI:1073637344
Name:ADJEPONG, JULIANA OSEI (MSW)
Entity Type:Individual
Prefix:MRS
First Name:JULIANA
Middle Name:OSEI
Last Name:ADJEPONG
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:JULIANA
Other - Middle Name:AMOATENG
Other - Last Name:ADJEPONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:34 MURRAY ST
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06710-1920
Mailing Address - Country:US
Mailing Address - Phone:203-756-8317
Mailing Address - Fax:203-756-8310
Practice Address - Street 1:34 MURRAY ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06710-1920
Practice Address - Country:US
Practice Address - Phone:203-756-8317
Practice Address - Fax:203-756-8310
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2008-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004068284Medicaid
CT004215308Medicaid