Individual
LARRY BEVERLY II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
391 POMFRET ST, PUTNAM, CT 06260-1852
(860) 963-6763
(860) 963-6764
Mailing address
391 POMFRET ST, PUTNAM, CT 06260-1852
(860) 963-6763
(860) 963-6764
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/03/2013
Last updated
06/03/2013
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