Individual
MRS. SHANNON JOYCE DEPODESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
45 MERIDEN AVE, SOUTHINGTON, CT 06489-3214
(860) 621-9559
Mailing address
131 ROSEANNA RD, PLANTSVILLE, CT 06479-1224
(860) 628-7427
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
001839
CT
Other
Enumeration date
03/06/2015
Last updated
03/06/2015
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