Individual
MRS. THERESA BOATENG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
150 SHINGLE HILL RD, WEST HAVEN, CT 06516
(203) 843-8182
(203) 690-5100
Mailing address
150 SHINGLE HILL RD, WEST HAVEN, CT 06516-5539
(203) 843-8182
(203) 690-5100
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
HCA.0001442
CT
376J00000X
Homemaker
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82-46333610
—
CT
01
—
82-4633610
HOME CARE
CT
Enumeration date
07/26/2018
Last updated
09/25/2018
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