Provider Demographics
NPI:1477846319
Name:MEALHA, SUSANA L (MSW)
Entity Type:Individual
Prefix:MRS
First Name:SUSANA
Middle Name:L
Last Name:MEALHA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 TOWER AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06112-1273
Mailing Address - Country:US
Mailing Address - Phone:860-714-9200
Mailing Address - Fax:860-714-8516
Practice Address - Street 1:675 TOWER AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06112-1273
Practice Address - Country:US
Practice Address - Phone:860-714-9200
Practice Address - Fax:860-714-8516
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker