Individual
MS. CONNIE VANRHEENEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.I.C.S.W
Contact information
Practice address
158 MOUNT AUBURN ST, CAMBRIDGE, MA 02138-4876
(617) 417-1805
(617) 547-3735
Mailing address
158 MOUNT AUBURN ST, CAMBRIDGE, MA 02138-4876
(617) 417-1805
(617) 547-3735
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
110845
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1857886
—
MA
01
—
P07872
BLUE CROSS BLUE SHIELD
MA
Enumeration date
12/11/2006
Last updated
07/08/2007
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