Individual
NICOLE MARIE CHARBONNEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
304 MAIN ST, FARMINGTON, CT 06032-2985
(860) 674-1824
Mailing address
57 BROOKLINE AVE, WEST SPRINGFIELD, MA 01089-2209
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2201
CT
Other
Enumeration date
07/10/2022
Last updated
07/10/2022
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