Provider Demographics
NPI:1710186101
Name:JETER-ROSEMOND, BELINDA (BS)
Entity type:Individual
Prefix:MS
First Name:BELINDA
Middle Name:
Last Name:JETER-ROSEMOND
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BEACH RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-2840
Mailing Address - Country:US
Mailing Address - Phone:860-714-2932
Mailing Address - Fax:860-714-8551
Practice Address - Street 1:675 TOWER AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06112-1260
Practice Address - Country:US
Practice Address - Phone:860-714-2932
Practice Address - Fax:860-714-8551
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)