Individual
MARY BOSS WITHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
141 TUCKIE RD, NORTH WINDHAM, CT 06256-1317
(860) 465-2610
Mailing address
112 MANSFIELD AVE, WILLIMANTIC, CT 06226-2045
(860) 456-9116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
001190
CT
Other
Enumeration date
10/01/2013
Last updated
10/01/2013
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