License Detail

NameURBAN LINDA JIVIDEN
AddressBLOOMFIELDCT
ProfessionLICENSED CLINICAL SOCIAL WORK
License No027272
Date of Licensure09/01/04  (OriginallylicensedasaCertifiedSocialWorkeron12/31/81)
Additional QualificationP -3-year psychotherapy privilege
StatusNOT REGISTERED
Registered through last day of

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