Individual
MS. ELISHA HAZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 BOSTON POST RD, ORANGE, CT 06477-3235
(203) 891-0655
Mailing address
109 BOSTON POST RD, ORANGE, CT 06477-3235
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
1383
CT
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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