Individual
KATHLEEN ROACH-SEPERACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7-9 ISAAC ST, NORWALK, CT 06850-4102
(203) 673-9173
Mailing address
235 GROVERS AVE, BRIDGEPORT, CT 06605-3452
(203) 673-9173
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
006715
CT
Other
Enumeration date
12/11/2018
Last updated
06/14/2021
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