Individual
MARIANA TAMAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1145 POQUONNOCK RD, GROTON, CT 06340-4620
(860) 446-9960
Mailing address
580 GOOSE LN, GUILFORD, CT 06437-2163
(203) 889-6716
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5437
CT
Other
Enumeration date
07/28/2020
Last updated
07/28/2020
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