Provider Demographics
NPI:1427015429
Name:HEPWORTH, JERI (PHD)
Entity Type:Individual
Prefix:DR
First Name:JERI
Middle Name:
Last Name:HEPWORTH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 WOODLAND ST
Mailing Address - Street 2:ASYLUM HILL FAMILY MEDICINE CENTER, INC.
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1207
Mailing Address - Country:US
Mailing Address - Phone:860-714-4212
Mailing Address - Fax:860-714-8080
Practice Address - Street 1:99 WOODLAND ST
Practice Address - Street 2:ASYLUM HILL FAMILY MEDICINE CENTER, INC.
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1207
Practice Address - Country:US
Practice Address - Phone:860-714-4212
Practice Address - Fax:860-714-8080
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000033106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist