Individual
MS. LORRAINE DIANE JOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
16 MIDWOOD AVE, WATERBURY, CT 06708-2431
(203) 591-1938
Mailing address
PO BOX 1160, MIDDLEBURY, CT 06762-1160
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
004166
CT
Other
Enumeration date
11/24/2008
Last updated
11/24/2008
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