Individual
MIWAKO OHTA-AGRESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
25 NEWELL RD, D28, BRISTOL, CT 06010
(860) 584-4240
(860) 585-5852
Mailing address
25 NEWELL RD, D28, BRISTOL, CT 06010
(860) 584-4240
(860) 585-5852
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
000085
CT
Other
Enumeration date
09/06/2006
Last updated
07/08/2007
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