Individual
CANDACE I BODEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
89 RICHARDS RD, LITCHFIELD, CT 06759-3701
(860) 567-7792
Mailing address
89 RICHARDS RD, LITCHFIELD, CT 06759-3701
(860) 567-7792
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004074
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004258382
—
CT
Enumeration date
07/28/2006
Last updated
05/13/2013
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