Individual
EILEEN CORREIA-DEPAOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T
Contact information
Practice address
140 GRANDVIEW AVE, SUITE 104, WATERBURY, CT 06708-2505
(860) 919-4904
Mailing address
35 BALDWIN AVE, WATERBURY, CT 06706-1818
(860) 919-4904
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0006424
CT
376K00000X
Nurse's Aide
9995656
CT
Other
Enumeration date
04/12/2011
Last updated
04/12/2011
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