Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 12.006576 | CT |
NPI | 1023485208 |
---|---|
Provider Name | Jessica Lee Adelman |
First Address | Hamden, CT 06517-2321 |
Second Address | Hartford, CT 06105-2636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2015 |
Last Update Date | 23/06/2020 |