Individual
AUDREY NOVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
22 MASONIC AVE, WALLINGFORD, CT 06492-3048
(203) 679-6309
Mailing address
22 MASONIC AVE, WALLINGFORD, CT 06492-3048
(203) 679-6309
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4347
CT
Other
Enumeration date
09/21/2015
Last updated
09/21/2015
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