Organization
PHOENIX RISING PSYCHIATRIC SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER RICHELLO DNP, PMHNP-BC, APRN (DNP, PMHNP-BC, APRN)
(203) 632-6239
Entity
Organization
Contact information
Practice address
2389 MAIN ST STE 100, GLASTONBURY, CT 06033-4617
(203) 632-6239
Mailing address
PO BOX 4675, WALLINGFORD, CT 06492-7568
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/27/2024
Last updated
11/27/2024
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