Individual
MARISSA BENVENUTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
2800 MAIN ST, BRIDGEPORT, CT 06606-4292
(203) 576-6000
Mailing address
2800 MAIN ST, BRIDGEPORT, CT 06606-4201
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
13828
CT
Other
Enumeration date
09/30/2024
Last updated
01/30/2025
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