Stefanie Bourassa MSPT

NPI 1497925283 - Specialist - 174400000X

NPI Details
NPI 1497925283
Gender Female
Enumeration Date 03/07/2008
Last Updated 03/07/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
145 HAZARD AVE
SUITE B
ENFIELD CT, 06082-4521, US
Phone (860) 265-2571
Fax (860) 265-2574
Business Location
145 HAZARD AVE
SUITE B
ENFIELD CT, 06082-4521, US
Phone (860) 265-2571
Fax (860) 265-2574
Toxanomy
Taxonomy Code 174400000X
License State Connecticut
License Number 008279
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According to our database, Stefanie Bourassa MSPT NPI is 1497925283, taxonomy code is 174400000X and license number is 008279, license state is located at Connecticut. Stefanie Bourassa MSPT physically located at 145 Hazard Ave, Enfield CT, 06082-4521. NPI Number Stefanie Bourassa MSPT has the Individual type.

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1497925283 NPI number is provided on an as is basis without warranty of any kind. 1497925283 is maintained by the National Plan & Provider Enumeration System. The contents of Stefanie Bourassa MSPT are for informational purposes only.