Individual
CORRINE LAKE SIESER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
303 WINTHROP RD, DEEP RIVER, CT 06417-1668
(860) 304-9201
Mailing address
303 WINTHROP RD, DEEP RIVER, CT 06417-1668
(860) 304-9201
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/02/2017
Last updated
02/02/2017
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