Individual
MARISSA LAHAIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
330 POMFRET ST, PUTNAM, CT 06260-1854
(860) 928-2736
Mailing address
330 POMFRET ST, PUTNAM, CT 06260-1854
(860) 928-2736
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4781
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008035051
—
CT
Enumeration date
09/08/2011
Last updated
10/24/2018
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