Individual
CRISTINA CONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
124 FORT HILL RD, GROTON, CT 06340-4335
(860) 333-7502
(860) 323-8172
Mailing address
20 TRYON AVE, GROTON, CT 06340-5532
(860) 245-5409
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
006510
CT
1041C0700X
Clinical Social Worker
110254
MA
1041C0700X
Clinical Social Worker
ISW01565
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6651869
—
RI
Enumeration date
09/25/2006
Last updated
02/10/2021
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