Individual
QUANISHA BIRTHWRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
158 NILAN ST, HARTFORD, CT 06106-3782
(860) 768-2301
Mailing address
158 NILAN ST, HARTFORD, CT 06106-3782
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119007548
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119007548
OT
VA
Enumeration date
01/23/2018
Last updated
01/23/2018
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