Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 005388 | CT |
NPI | 1003038696 |
---|---|
Provider Name | Ms. Kendra Lyn Labrie |
First Address | Plainville, CT 06062 |
Second Address | Plainville, CT 06062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 08/07/2007 |