Individual
JENNA PIVA LARAMIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
255 HEMPSTEAD ST, NEW LONDON, CT 06320-6204
(860) 443-2896
Mailing address
31 FOWLER CT, NEW LONDON, CT 06320-3309
(208) 819-4864
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/28/2013
Last updated
08/28/2013
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