Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 006994 | CT |
NPI | 1639572357 |
---|---|
Provider Name | Karen Perron |
First Address | Manchester, CT 06042-3067 |
Second Address | East Hartford, CT 06108-7400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2014 |
Last Update Date | 08/10/2014 |