Organization
JESSICA R. PAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE CULLEN (MEDICAL BILLING MANAGER)
(203) 367-5515
Entity
Organization
Contact information
Practice address
57 PLAINS RD STE 1B, MILFORD, CT 06461-2573
(203) 913-6883
Mailing address
7 GLENARDEN RD, TRUMBULL, CT 06611-5515
(203) 913-6883
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004069985
—
CT
Enumeration date
12/17/2019
Last updated
12/17/2019
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