Individual
SHAUNNA FENNELLY STCLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
90 S MAIN ST, MIDDLETOWN, CT 06457-3649
(860) 358-6300
Mailing address
90 S MAIN ST, MIDDLETOWN, CT 06457-3649
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3276
CT
Other
Enumeration date
01/19/2015
Last updated
02/21/2018
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