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Individual

CHERYL TEDESCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
205 WAKELEE AVE, ANSONIA, CT 06401-1234
(203) 735-7481
(203) 735-5021
Mailing address
19 L HERMITAGE DR, SHELTON, CT 06484-3829

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004138
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
140004138CT03
BLUE CROSS
CT
Enumeration date
09/02/2006
Last updated
07/08/2007
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