Individual
JENNIFER T. CIASULLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
5 LAKE RD, SHELTON, CT 06484-2967
(203) 922-3674
Mailing address
5 LAKE RD, SHELTON, CT 06484-2967
(203) 922-3674
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
002573
CT
Other
Enumeration date
05/13/2013
Last updated
10/14/2014
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