Individual
MISS JENNA SUE STANISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13 PORTER RD, WOLCOTT, CT 06716-1414
(203) 707-3052
Mailing address
13 PORTER RD, WOLCOTT, CT 06716-1414
(203) 707-3052
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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