Individual
DONNA NICKDOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
205 WAKELEE AVE, ANSONIA, CT 06401-1234
(203) 735-7481
Mailing address
38 PURDY HILL RD, MONROE, CT 06468-2215
(203) 924-9426
(203) 924-9426
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003580
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140003580CT01
BLUE CROSS
CT
Enumeration date
09/06/2006
Last updated
12/13/2017
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