Individual
KRISTY ANN O'BRIEN BARACCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3 S WIG HILL RD, CHESTER, CT 06412-1106
(860) 526-5316
Mailing address
189 GIFFORD LN, BOZRAH, CT 06334-1318
(860) 705-6801
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
000785
CT
225700000X
Massage Therapist
004709
CT
Other
Enumeration date
03/26/2009
Last updated
03/26/2009
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