Individual
DETWANETTE WOODERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
255 ROBBINS ST, WATERBURY, CT 06708-2762
(860) 919-6368
Mailing address
133 SOUTHMAYD RD FL 2, WATERBURY, CT 06705-2037
(860) 919-6368
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8569
CT
Other
Enumeration date
07/26/2016
Last updated
07/26/2016
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