Provider Demographics
NPI:1811512023
Name:HEWITT-WEDDERBURN, VALENTINA JACQUELINE
Entity type:Individual
Prefix:
First Name:VALENTINA
Middle Name:JACQUELINE
Last Name:HEWITT-WEDDERBURN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 ALBANY AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06112-2132
Mailing Address - Country:US
Mailing Address - Phone:860-246-2323
Mailing Address - Fax:
Practice Address - Street 1:1229 ALBANY AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06112-2132
Practice Address - Country:US
Practice Address - Phone:860-246-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2399106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist