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Individual

MRS. KIMBERLY PATTERSON MISHRIKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
15 MERCER AVE, SCHOOL BASED HEALTH CENTER, EAST HARTFORD, CT 06118-1517
(860) 622-5513
Mailing address
10 CANDLELIGHT DR, GLASTONBURY, CT 06033-2537
(860) 633-3595

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
006850
STATE LICENCE
CT
Enumeration date
09/15/2008
Last updated
09/18/2008
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