Individual
NISHA ELIZEBETH JOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S
Contact information
Practice address
1151 WASHINGTON ST APT D2, MIDDLETOWN, CT 06457-2935
(203) 444-6767
Mailing address
1151 WASHINGTON ST APT D2, MIDDLETOWN, CT 06457-2935
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4884
CT
Other
Enumeration date
05/02/2020
Last updated
05/02/2020
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