Individual
MRS. KATHLEEN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
FLEET & FAMILY SUPPORT CENTER, BOX 93 NAVSUBASENLON, GROTON, CT 06349-5093
(860) 694-4961
(860) 694-4018
Mailing address
323 MT PARNASSUS RD, EAST HADDAM, CT 06423
(860) 873-3439
(860) 873-3439
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
006591
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006591
LCSW
CT
Enumeration date
07/29/2006
Last updated
04/09/2009
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