Individual
DESIRAE PETTIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
33 BEACH AVE, TERRYVILLE, CT 06786-6317
(203) 592-4593
Mailing address
33 BEACH AVE, TERRYVILLE, CT 06786-6317
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NA91285300
CT
Other
Enumeration date
04/30/2020
Last updated
04/30/2020
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