Individual
NICOLE MUCKENHIRN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
121 E HADDAM COLCHESTER TPKE, MOODUS, CT 06469-1240
(860) 204-1340
Mailing address
121 E HADDAM COLCHESTER TPKE, MOODUS, CT 06469-1240
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/09/2020
Last updated
04/09/2020
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