Individual
JOHANNA ULLOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
394 BURR RD, SOUTHBURY, CT 06488-2789
(917) 777-4303
Mailing address
394 BURR RD, SOUTHBURY, CT 06488-2789
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
12/22/2023
Last updated
12/22/2023
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