Individual
KATHLEEN DIANE SCHOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
103 JASMINE CIR, MILFORD, CT 06461-1789
(203) 882-1457
Mailing address
103 JASMINE CIR, MILFORD, CT 06461-1789
(203) 882-1457
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000723
CT
101YP2500X
Professional Counselor
Primary
001435
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008038045
—
CT
Enumeration date
10/03/2006
Last updated
08/08/2016
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