Individual
KATHLEEN AMANDA WALERYSZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
426 STATE ST, PORTSMOUTH, NH 03801-4049
(707) 654-4325
Mailing address
8 RIDGEWOOD DR # A, KITTERY, ME 03904-1046
(207) 337-0456
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2261
NH
Other
Enumeration date
09/06/2019
Last updated
09/06/2019
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