Individual
LISANNY MENDEZ CASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
458 GRAND AVE, NEW HAVEN, CT 06513-3856
(860) 462-6420
Mailing address
458 GRAND AVE STE 103, NEW HAVEN, CT 06513-3873
(860) 462-6420
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
CT
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
10/25/2021
Last updated
02/09/2022
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