Provider Demographics
NPI:1932533403
Name:MARUCCI, IOLANDA F (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:IOLANDA
Middle Name:F
Last Name:MARUCCI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 BLUEBERRY KNLS
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1716
Mailing Address - Country:US
Mailing Address - Phone:203-768-4427
Mailing Address - Fax:
Practice Address - Street 1:92 BLUEBERRY KNLS
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-1716
Practice Address - Country:US
Practice Address - Phone:203-768-4427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-02
Last Update Date:2013-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0080641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical