Individual
JEFFREY HADDAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
304 MAIN ST UNIT A, FARMINGTON, CT 06032-2985
(860) 674-1824
Mailing address
84 QUEEN ST APT 1, BRISTOL, CT 06010-5802
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
004010
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780858621
—
CT
Enumeration date
02/18/2019
Last updated
02/18/2019
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