Individual
HEATHER M MCDONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
158 STATE ST, MERIDEN, CT 06450-3202
(203) 237-1448
Mailing address
158 STATE ST, MERIDEN, CT 06450-3202
(203) 237-1448
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
005233
CT
225100000X
Physical Therapist
Primary
005233
CT
2251P0200X
Pediatric Physical Therapist
005233
CT
2251X0800X
Orthopedic Physical Therapist
005233
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
574217
—
CT
Enumeration date
04/22/2008
Last updated
06/24/2022
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