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Individual

MICHELLE DARA WIDDOWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-C

Contact information

Practice address
105 TECHNOLOGY DR FL 2, TRUMBULL, CT 06611-6348
(475) 228-0961
(203) 283-6490
Mailing address
105 TECHNOLOGY DR FL 2, TRUMBULL, CT 06611-6348
(475) 228-0961
(203) 283-6490

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
10.146391
CT
163W00000X
Registered Nurse
606396
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
12.014410
CT

Other

Enumeration date
01/29/2016
Last updated
06/02/2025
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