Individual
MIRA SIEWERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 COLLIE BROOK RD, EAST HAMPTON, CT 06424-1642
(860) 853-8354
Mailing address
25 COLLIE BROOK RD, EAST HAMPTON, CT 06424-1642
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
09/02/2021
Last updated
09/02/2021
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