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Individual

MARIA LORETTO LACAYO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., LPC

Contact information

Practice address
124 WOODRIDGE DR S, STAMFORD, CT 06902-8334
(203) 979-8974
Mailing address
124 WOODRIDGE DR S, STAMFORD, CT 06902-8334
(203) 979-8974

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002053
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
46-2632131
TAX IDENTIFICATION NUMBER
CT
Enumeration date
08/31/2011
Last updated
08/31/2011
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