Individual
LISA FERNEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1 CARE LN, WEST HAVEN, CT 06516-2601
(203) 934-7955
Mailing address
28 FILBERT ST, HAMDEN, CT 06517-1312
(203) 248-3609
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000642
CT
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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