Individual
MELISSA MUSTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 TOMPKINS ST, WATERBURY, CT 06708-1458
(203) 419-0381
(203) 419-0389
Mailing address
22 TOMPKINS ST, WATERBURY, CT 06708-1458
(203) 419-0381
(203) 419-0389
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1607
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004190328
—
CT
Enumeration date
05/03/2016
Last updated
05/03/2016
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