Individual
KRISTEN WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
51 BROAD ST, FAMILY ADVOCACY, MIDDLETOWN, CT 06457-3204
(860) 358-3401
(860) 358-3403
Mailing address
51 BROAD ST, FAMILY ADVOCACY, MIDDLETOWN, CT 06457-3204
(860) 358-3401
(860) 358-3403
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7253
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7253
CT LCSW LICENSE #
CT
Enumeration date
03/25/2010
Last updated
03/25/2010
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