Individual
CATHERINE M CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1220 DEWEY AVE, BLDG 1, WAUWATOSA, WI 53213-2504
(414) 454-6506
(414) 454-6450
Mailing address
1220 DEWEY AVE, BLDG 1, WAUWATOSA, WI 53213-2504
(414) 454-6506
(414) 454-6450
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1972-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39723400
—
WI
Enumeration date
07/10/2007
Last updated
07/10/2007
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