Individual
MS. BONNIE A REDDEROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
61 S MAIN ST STE 307, WEST HARTFORD, CT 06107-2403
(860) 523-0288
Mailing address
61 S MAIN ST STE 307, WEST HARTFORD, CT 06107-2403
(860) 523-0288
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
002265
CT
1041C0700X
Clinical Social Worker
002265CT
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140002265CT01
ANTHEM BCBS
CT
Enumeration date
02/14/2007
Last updated
10/03/2023
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