Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 12854 | CT |
NPI | 1538706338 |
---|---|
Provider Name | Marielle Jean Handley |
First Address | Durham, CT 06422-1010 |
Second Address | New Britain, CT 06053-2298 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2019 |
Last Update Date | 08/08/2021 |