Individual
MICHELLE DESOUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31 VAUXHALL ST, NEW LONDON, CT 06320-5723
(860) 442-4363
Mailing address
31 VAUXHALL ST, NEW LONDON, CT 06320-5723
(860) 442-4363
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
010830
CT
Other
Enumeration date
01/19/2017
Last updated
06/28/2023
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