Individual
KELLY M RADOCCHIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LADC, CAC
Contact information
Practice address
140 GLASTONBURY BLVD, SUITE 25, GLASTONBURY, CT 06033-4402
(860) 644-0300
Mailing address
225 OAKLAND RD, UNIT 106, SOUTH WINDSOR, CT 06074-2866
(860) 646-0300
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004939
CT
Other
Enumeration date
03/05/2012
Last updated
03/05/2012
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