Individual
LISA STODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
75 GREAT POND RD, SIMSBURY, CT 06070-1980
(860) 658-3986
Mailing address
75 GREAT POND RD, SIMSBURY, CT 06070-1980
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
000273
CT
Other
Enumeration date
08/13/2019
Last updated
08/13/2019
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