Individual
MS. SABRENA DIANA LARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
330 WESTERN BLVD STE 101, GLASTONBURY, CT 06033-4383
(860) 657-4723
Mailing address
30 BABULA RD, THOMPSON, CT 06277-1401
(860) 208-8611
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000438
CT
2255A2300X
Athletic Trainer
0334
NH
2255A2300X
Athletic Trainer
1625
MA
2255A2300X
Athletic Trainer
2009003225
MO
Other
Enumeration date
01/08/2008
Last updated
03/23/2020
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