Individual
MRS. TINA MARIE AHLQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1250 SILVER ST, MIDDLETOWN, CT 06457-3946
(860) 346-0300
Mailing address
1250 SILVER ST, MIDDLETOWN, CT 06457-3946
(860) 346-0300
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
CT
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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