Individual
SHIKA CARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
56 FRANKLIN ST STE 1, WATERBURY, CT 06706-1281
(203) 709-6479
Mailing address
1485 WALNUT ST., VICTORIA, BRITISH COLUMBIA 817
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
CT
Other
Enumeration date
04/13/2018
Last updated
04/13/2018
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