Individual
JESSICA ANNE COLLELO-BIBEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
554 LIBERTY HWY STE 6, PUTNAM, CT 06260-2728
(860) 412-4598
Mailing address
PO BOX 541, BROOKLYN, CT 06234-0541
(860) 428-2249
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
09144
CT
1041C0700X
Clinical Social Worker
Primary
9144
CT
Other
Enumeration date
11/19/2018
Last updated
02/17/2023
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