Individual
LEAH MATTIACCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
400 W CAMPUS DR, ORANGE, CT 06477-3646
(203) 785-2389
Mailing address
400 W CAMPUS DR, ORANGE, CT 06477-3646
(203) 785-2389
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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