Individual
JOEL DONNEL KIRKLAND SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
30 BREWSTER ST, NEW HAVEN, CT 06511-1804
(203) 800-6144
Mailing address
30 BREWSTER ST, NEW HAVEN, CT 06511-1804
(203) 800-6144
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
HCA.0001408
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43095686-000
CONSUMER PROTECTION
CT
05
—
HCA.0001408
—
CT
Enumeration date
03/22/2018
Last updated
03/22/2018
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