Individual
KENNETH MICHAEL BIBALO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
93 OAKWOOD RD, NIANTIC, CT 06357-2038
(860) 389-5148
Mailing address
93 OAKWOOD RD, NIANTIC, CT 06357-2038
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
16345
CT
Other
Enumeration date
03/11/2026
Last updated
03/11/2026
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