Individual
KATHLEEN MILDRED HUMPAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, NCBTMB
Contact information
Practice address
138 WOOD POND RD, GLASTONBURY, CT 06033-3702
(860) 508-4245
(860) 659-2559
Mailing address
138 WOOD POND RD, GLASTONBURY, CT 06033-3702
(860) 508-4245
(860) 659-2559
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
R19817
CT
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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