Individual
KAELYN BONAVENTURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 OLD COACH LN, STRATFORD, CT 06614-1626
(203) 522-0646
Mailing address
120 OLD COACH LN, STRATFORD, CT 06614-1626
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4853
CT
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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