Individual
CARISSA VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MC CCC-SLP
Contact information
Practice address
60 CONNOLLY PKWY BLDG 17A, HAMDEN, CT 06514-2532
(203) 230-2815
Mailing address
60 CONNOLLY PKWY BLDG 17A, HAMDEN, CT 06514-2532
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
004536
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004536
CT DEPARTMENT OF PUBLIC HEALTH STATE LICENSE
CT
Enumeration date
09/12/2018
Last updated
09/12/2018
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