Individual
LARISA MASIAROVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18 E GATE LN, HAMDEN, CT 06514-2229
(203) 430-2496
Mailing address
18 E GATE LN, HAMDEN, CT 06514-2229
(203) 430-2496
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
003692
CT
225X00000X
Occupational Therapist
14324
CA
Other
Enumeration date
09/26/2014
Last updated
09/26/2014
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