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Individual

MS. SHAUNA BOUTEILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
400 COLUMBUS AVE, NEW HAVEN, CT 06519-1233
(203) 503-3000
Mailing address
400 COLUMBUS AVE, NEW HAVEN, CT 06519-1233
(203) 503-3000

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
07/08/2021
Last updated
05/01/2024
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