Individual
TARA PETERS BASILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
91 NORTHWEST DR, PLAINVILLE, CT 06062-1534
(203) 988-2765
Mailing address
111 DODGE AVE, EAST HAVEN, CT 06512-3337
(203) 988-2765
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/28/2017
Last updated
11/28/2017
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