Organization
MARY KINSELLA-SHAW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNILYN TELESCA (BILLER)
(203) 668-1613
Entity
Organization
Contact information
Practice address
31 WARRENVILLE RD, MANSFIELD CENTER, CT 06250-1260
(860) 450-1173
Mailing address
31 WARRENVILLE RD, MANSFIELD CENTER, CT 06250-1260
(860) 450-1173
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
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