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General NPI Number Information
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NPI Number | 1548092414
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Entity Type | Organization
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Legal Business Name | VESSEL HEALING COLLECTIVE PLLC
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Dates
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Enumeration Date | 08/19/2024
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 443 NORTON PKWY
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City | NEW HAVEN
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State | CT
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Zip | 06511-2830
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Country | US
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Telephone | 203-675-5308
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Fax |
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Provider Business Mailing Address
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Address Line | 443 NORTON PKWY
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City | NEW HAVEN
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State | CT
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Zip | 06511-2830
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Country | US
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Telephone | 203-675-5308
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Fax |
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Authorized Official
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Title or Position | REGISTERED AGENT
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Name | MRS. DEVORAH L KAMMAN
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Credential | RN
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Telephone | 203-675-5308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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