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Individual

KATHLEEN ACKLEY BANNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S

Contact information

Practice address
162 WEST ST STE F, CROMWELL, CT 06416-4405
(860) 613-9930
(860) 623-9952
Mailing address
162 WEST ST STE F, CROMWELL, CT 06416-4405
(860) 613-9930

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
005706
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
347698
NBCOT
Enumeration date
09/05/2018
Last updated
10/27/2021
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