Individual
MS. DARLENE MARIE HAVILAND
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
113 ELM ST, ENFIELD, CT 06082-3700
(860) 741-2225
(860) 741-2229
Mailing address
25 PINE GROVE DR, SOUTH HADLEY, MA 01075-2196
(508) 832-9572
(508) 832-4758
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001494
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290001494CT01
ANTHEM BLUE CROSS
CT
Enumeration date
01/16/2006
Last updated
07/09/2007
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