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Organization
LIFESPAN COLLABORATIVE SERVICES LLC
Active
Organization
LIFESPAN COLLABORATIVE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DILICE ROBERTSON DNP-APRN (MEMBER)
(203) 887-1278
Entity
Organization
Contact information
Practice address
71 OXFORD RD, OXFORD, CT 06478-1900
(203) 463-4558
Mailing address
2390 STATE ST, UNIT 2E, HAMDEN, CT 06517-3716
(203) 887-1278
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
003973
CT
Other
Enumeration date
05/18/2015
Last updated
05/18/2015
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