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1114462561
SHANTELLE BROKAW
WATERBURY, CT
NPI
1114462561
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: CT 6831)
Enumeration Date
2016-12-21
Last Update Date
2020-04-14
Business Address
Mrs. SHANTELLE BROKAW
128 CEDAR AVE
WATERBURY, CT 06705-2700
Phone number: 203-757-9271
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Mailing Address
Mrs. SHANTELLE BROKAW
500 ALBANY AVE
HARTFORD, CT 06120-2508
Phone number: 860-249-9625
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