Individual
MIRIAN I LARACUENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
55 FISHFRY ST, HARTFORD, CT 06120-1203
(860) 247-8300
Mailing address
55 FISHFRY ST, HARTFORD, CT 06120-1203
(860) 247-8300
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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