Provider Demographics
NPI:1912217076
Name:BUTLER, JENNIFER AYANNA (JD, MSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:AYANNA
Last Name:BUTLER
Suffix:
Gender:F
Credentials:JD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 TEMPLE ST
Mailing Address - Street 2:APARTMENT 807
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06103-1310
Mailing Address - Country:US
Mailing Address - Phone:860-402-8428
Mailing Address - Fax:
Practice Address - Street 1:21 TEMPLE ST
Practice Address - Street 2:APARTMENT 807
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06103-1310
Practice Address - Country:US
Practice Address - Phone:860-402-8428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical