Individual
BREANNE DUFAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06032
(860) 679-2000
Mailing address
378 SOUTH RD, HAMPDEN, MA 01036-9100
(413) 563-9224
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
12199
CT
Other
Enumeration date
04/12/2018
Last updated
06/28/2018
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