Individual
MRS. LISA ANN TRUDEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
43 BROADLEAF LN, ENFIELD, CT 06082-5501
(860) 995-7889
Mailing address
43 BROADLEAF LN, ENFIELD, CT 06082-5501
(860) 995-7889
Taxonomy
Speciality
Code
Description
License number
State
174V00000X
Clinical Ethicist
Primary
000321
CT
Other
Enumeration date
10/13/2014
Last updated
10/13/2014
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