Individual
KIMBERLY O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
202 PLAYHOUSE COR, SOUTHBURY, CT 06488-2265
(203) 518-5380
Mailing address
12 GRAND PL, NEWTOWN, CT 06470-2114
(203) 597-7927
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1615
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MEDICAID ID-00804972
—
CT
Enumeration date
07/27/2013
Last updated
10/18/2023
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