Individual
LAURA LEE FASANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMHC
Contact information
Practice address
1230 PLEASANT ST, BARRE, MA 01005-9313
(978) 808-6012
Mailing address
1230 PLEASANT ST, BARRE, MA 01005-9313
(978) 808-6012
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6235
MA
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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