Individual
JACQUELINE MICHELLE HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HS
Contact information
Practice address
15 MOHEGAN AVE, NEW LONDON, CT 06320-8100
(860) 444-8402
Mailing address
2 CHURCH ST, APT. C, NORWICH, CT 06360-5050
(617) 959-1271
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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