Individual
BRIANNE VIVIAN MIKULLITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
209 ROOT RD, WESTFIELD, MA 01085-9801
(413) 568-3942
Mailing address
11 STONY BROOK RD, ENFIELD, CT 06082-4024
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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