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Individual

KAITLYN DESJARDIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
CREC-SOUNDBRIDGE, 123 PROGRESS DRIVE, WETHERSFIELD, CT 06109-0610
(860) 529-4260
(860) 257-8500
Mailing address
CREC-SOUNDBRIDGE, 123 PROGRESS DRIVE, WETHERSFIELD, CT 06109-2450
(860) 529-4260

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
000619
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000619
LICENSE
CT
Enumeration date
04/09/2019
Last updated
04/09/2019
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