Individual
MARNIE CAPOBIANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
145 GROVE ST, WATERBURY, CT 06710-2202
(203) 753-7205
Mailing address
145 GROVE ST, WATERBURY, CT 06710-2202
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
000862
CT
Other
Enumeration date
11/12/2012
Last updated
11/12/2012
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