Individual
MRS. STACI ANN O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
55 AUDI LN, STRATFORD, CT 06614-3252
(203) 296-1935
Mailing address
55 AUDI LN, STRATFORD, CT 06614-3252
(203) 296-1935
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
001190
CT
Other
Enumeration date
02/19/2013
Last updated
08/14/2013
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