Individual provider · Type 1 NPI

Tia Simone Gardner

Student in an Organized Health Care Education/Training Program · Waterbury, CT

NPI number 1679155014 Active

Practice location

402 E Main St
Waterbury, CT 06702-1701

Call (203) 574-9000 Map

Fax (203) 574-9006

Mailing address

141 E Main St
Waterbury, CT 06702-2310

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1679155014

Tia Simone Gardner's National Provider Identifier is 1679155014, issued on Apr 26, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Waterbury, CT. The record was last updated on Apr 26, 2021.