Individual
JEREMY MICHAEL DONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22 BLUE CLIFF TER APT 203, NEW HAVEN, CT 06513-4720
(631) 455-0935
Mailing address
22 BLUE CLIFF TER APT 203, NEW HAVEN, CT 06513-4720
(631) 455-0935
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7054
CT
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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