Individual
MELISSA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
469 W MAIN ST, BRANFORD, CT 06405-3400
(203) 315-6784
Mailing address
69 JACKSON ST, ANSONIA, CT 06401-1211
(203) 751-7091
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
005196
CT
Other
Enumeration date
07/10/2019
Last updated
07/10/2019
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