Individual
MRS. CECILIA EBAI TAKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
915 ELLA T GRASSO BLVD, NEW HAVEN, CT 06519-5516
(561) 444-3512
Mailing address
13206 OYSTERCATCHER LN, BOWIE, MD 20720-4766
(240) 565-8977
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
207210
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0024186692
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
011979
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APRN11015301
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
R187498
MD
Other
Enumeration date
03/05/2020
Last updated
03/20/2024
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