Provider Information for 1245929173
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KATHERYN JEANNE CLOUD LCSW
Sex: Female
NPI: 1245929173
Last Updated: 2023-05-05
Certification Date: 2023-05-05
Certification Date: 2023-05-05
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1245929173 | ||||||||
| Enumeration Date | 2023-05-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 88 GEORGIA ST GROTON, CT 06340-6123 United States Phone: 860-938-3925 | Fax: | ||||||||
| Primary Practice Address | 88 GEORGIA ST GROTON, CT 06340-6123 United States Phone: 860-938-3925 | Fax: | ||||||||
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