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Individual

ELISABETH A PROSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CBD

Contact information

Practice address
255 HIGH ST, WILLIMANTIC, CT 06226-1341
(860) 933-3854
Mailing address
255 HIGH ST, WILLIMANTIC, CT 06226-1341
(860) 933-3854

Taxonomy

Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
14882
CT

Other

Enumeration date
02/24/2023
Last updated
02/24/2023
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