Individual
MS. JESSICA ARIEL MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
428 COLUMBUS AVE, NEW HAVEN, CT 06519-1233
(203) 503-3000
Mailing address
1904 SHEPARD AVE, HAMDEN, CT 06518-1842
(203) 804-0492
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
12.010803
CT
Other
Enumeration date
08/09/2022
Last updated
08/09/2022
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