Individual
AVA FRACASSINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
999 SUMMER ST # 104, STAMFORD, CT 06905-5546
(203) 504-2408
Mailing address
66 BANKSIDE ST, BRIDGEPORT, CT 06606-2617
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
004703
CT
Other
Enumeration date
05/22/2017
Last updated
05/22/2017
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