NPI 1497925283

Stefanie Bourassa, MSPT

Practitioner Specialist Enfield, CT

Practice location

Address: 145 Hazard Ave Suite B, Enfield, CT 06082-4521
Phone: (860) 265-2571
Fax: (860) 265-2574

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 008279 (CT)

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Registry record

NPI: 1497925283
Entity type: Individual
Sex (as registered): Female
NPI issued: 7 Mar 2008
Record last updated: 7 Mar 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.