Individual
ALISA DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
950 CAMPBELL AVE, WEST HAVEN, CT 06516-2770
(203) 932-5711
Mailing address
29 MYRTLE RD, PORTLAND, CT 06480-1643
(860) 966-3808
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCT.0013855
CT
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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