Individual
CHERYL A. CANTILLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
46 ROXBURY RD, NIANTIC, CT 06357-1836
(860) 287-7107
Mailing address
46 ROXBURY RD, NIANTIC, CT 06357-1836
(860) 287-7107
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
001883
CT
323P00000X
Psychiatric Residential Treatment Facility
8902
MA
Other
Enumeration date
08/26/2009
Last updated
08/26/2009
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