Redderoth, Bonnie A
Redderoth, Bonnie A is an sole proprietor health care provider with primary practice located at 61 S Main St Ste 307 , West Hartford CT 06107-2403. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Redderoth, Bonnie A can be contacted via phone (860) 523-0288.Contact Information
Primary practice address
61 S Main St Ste 307
West Hartford CT 06107-2403
Phone: (860) 523-0288
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 002265CT | Connecticut |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 002265 | Connecticut |
Profile Details
| NPI number | 1356484125 |
|---|---|
| LBN Legal business name | Redderoth, Bonnie A |
| Credentials | MSW, LCSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 14th, 2007 |
| Last updated | Oct 3rd, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356484125 | NPPES |
| Connecticut | Other | 140002265CT01 | ANTHEM BCBS |
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