Individual
KANELA ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
334 N MAIN ST, WEST HARTFORD, CT 06117-2675
(860) 236-7771
Mailing address
785 PLEASANT VALLEY RD, SOUTH WINDSOR, CT 06074-4228
(860) 726-3595
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1504
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1504
ATHLETIC TRAINER LICENSE NUMBER
CT
Enumeration date
05/18/2020
Last updated
05/18/2020
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