Provider Information for 1669901880
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KATHLEEN MARIE CONNOLLY M.Ed, CADC
Sex: Female
NPI: 1669901880
Last Updated: 2017-06-10
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1669901880 | ||||||||
| Enumeration Date | 2017-06-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 9 BASSETT ST CHELSEA, MA 02150-1503 United States Phone: 617-889-0017 | Fax: | ||||||||
| Primary Practice Address | 1493 CAMBRIDGE ST CAMBRIDGE, MA 02139-1047 United States Phone: 617-661-5700 | Fax: | ||||||||
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