Individual
SUSAN BARTLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
850 BOLTON RD # U-85, STORRS MANSFIELD, CT 06269-9020
(860) 486-2629
(860) 486-5422
Mailing address
65 KANE ST, PROVIDER ENROLLMENT-ELLIE ATKINS, WEST HARTFORD, CT 06119-2110
(860) 523-6421
(860) 523-3701
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
000626
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004070496
—
CT
Enumeration date
06/21/2005
Last updated
04/15/2010
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