Individual
SANDRA LEE DIZENZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
88 NOTCH HILL RD, NORTH BRANFORD, CT 06471-1846
(203) 488-8000
Mailing address
5 S COVE RD, OLD SAYBROOK, CT 06475-2585
(860) 391-8444
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
001041
CT
Other
Enumeration date
09/22/2018
Last updated
09/22/2018
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