Individual
KELLY THERESA TOBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
153 HAZARD AVE, ENFIELD, CT 06082-4592
(860) 253-5020
Mailing address
2 WATERSIDE XING STE 401, WINDSOR, CT 06095-1587
(860) 697-3351
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
084503
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
009549
CT
Other
Enumeration date
09/13/2019
Last updated
03/02/2021
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