Individual
MARY ELIZABETH BASCOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1489 ENFIELD ST, ENFIELD, CT 06082-5540
(860) 989-3806
Mailing address
1489 ENFIELD ST, ENFIELD, CT 06082-5540
(860) 989-3806
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
MA
374J00000X
Doula
—
—
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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