Individual
AHISHA DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
141 E MAIN ST, WATERBURY, CT 06702-2310
(203) 580-4298
Mailing address
141 E MAIN ST, WATERBURY, CT 06702-2310
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
205204
CT
Other
Enumeration date
09/22/2023
Last updated
09/22/2023
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