JACQUELINE C MONGILLO
Occupational Therapist Assistant


Address: 156 Harding Ave, West Haven, CT 06516-6336

JACQUELINE C MONGILLO (Credential# 777367) is licensed (Occupational Therapist Assistant) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2013. The license expiration date date is July 31, 2015. The license status is INACTIVE.

Business Overview

JACQUELINE C MONGILLO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #49.001054. The credential type is occupational therapist assistant. The effective date is August 1, 2013. The expiration date is July 31, 2015. The business address is 156 Harding Ave, West Haven, CT 06516-6336. The current status is inactive.

Basic Information

Licensee Name JACQUELINE C MONGILLO
Credential ID 777367
Credential Number 49.001054
Credential Type Occupational Therapist Assistant
Business Address 156 Harding Ave
West Haven
CT 06516-6336
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2007-09-27
Effective Date 2013-08-01
Expiration Date 2015-07-31
Refresh Date 2015-11-10

Office Location

Street Address 156 HARDING AVE
City WEST HAVEN
State CT
Zip Code 06516-6336

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Ashley Elaina Fox 146 Harding Ave, West Haven, CT 06516-6336 Licensed Practical Nurse 2020-06-10 ~ 2020-09-30
Tara Christine Civitello 112 Harding Ave, West Haven, CT 06516-6336 Licensed Practical Nurse 2020-07-01 ~ 2021-06-30

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Competitor

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City WEST HAVEN
Zip Code 06516
License Type Occupational Therapist Assistant
License Type + County Occupational Therapist Assistant + WEST HAVEN

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Dataset Information

Data Provider Connecticut Department of Consumer Protection
Jurisdiction Connecticut
Related Datasets Connecticut Business Registrations, Connecticut Child Care Facilities

This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).

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