Individual
DESIREE LYNN LAVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
205 S MAIN ST, THOMASTON, CT 06787-1740
(860) 283-6255
Mailing address
205 S MAIN ST, THOMASTON, CT 06787-1740
(860) 384-0300
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
12.007545
CT
Other
Enumeration date
04/22/2018
Last updated
05/09/2019
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