Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JENNIFER DETLEFSEN, ATC, MHA
Active Sole ProprietorJENNIFER DETLEFSEN, ATC, MHA is a Athletic Trainer healthcare provider located in BETHLEHEM, Connecticut. NPI 1053825067 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · BETHLEHEM, CT
Registration Details
- NPI Number
- 1053825067
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 29, 2017 (8.5642300191056 yrs)
- Last Updated
- Nov 29, 2017
- License
-
764 (CT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
57 LONG MEADOW RDBETHLEHEM, CT, 067511116Browse CT providers · Browse ZIP 06751
- Phone
- 2034053369
- Primary Specialty
-
Athletic Trainer
2255A2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.