Individual
SHAMELIA SHANTE CROSBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 LILLEY ST, MANCHESTER, CT 06040-4232
(860) 888-9319
Mailing address
12 LILLEY ST, MANCHESTER, CT 06040-4232
(860) 888-9319
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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