Individual
DESIRAE TABOR-BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7 COLBURN RD, STAFFORD SPRINGS, CT 06076-3412
(860) 458-8361
Mailing address
7 COLBURN RD, STAFFORD SPRINGS, CT 06076-3412
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
008402
CT
Other
Enumeration date
07/03/2025
Last updated
07/03/2025
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