Individual
MRS. KRISTIN ELIZABETH KICZUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
255 HEMPSTEAD ST, NEW LONDON, CT 06320-6204
(860) 443-2896
(860) 442-5909
Mailing address
255 HEMPSTEAD ST, NEW LONDON, CT 06320-6204
(860) 443-2896
(860) 442-5909
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9238
CT
Other
Enumeration date
09/29/2010
Last updated
05/10/2017
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