Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 000386 | CT |
NPI | 1104090034 |
---|---|
Provider Name | Dr. Cassandra Mannhardt |
First Address | Bridgeport, CT 06604-5719 |
Second Address | Bridgeport, CT 06604-5719 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2008 |
Last Update Date | 22/04/2008 |