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Organization

LAURA PETIFORD PMHNP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAURA PETIFORD PMHNP (MEMBER)
(203) 445-6238
Entity
Organization

Contact information

Practice address
1525 KINGS HWY STE 206, FAIRFIELD, CT 06824-5321
(203) 445-6238
(203) 844-0179
Mailing address
1525 KINGS HWY STE 206, FAIRFIELD, CT 06824-5321

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
006417
CT

Other

Enumeration date
03/30/2018
Last updated
03/30/2018
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