Larissa Sue Cabral

Individual provider Active NPI Marriage & Family Therapist · Windsor, CT

NPI 1063757409 · NPPES record last updated Dec 11, 2012

Key facts

NPI
1063757409
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
001421 (CT)
Practice address
41 Mechanic St
Windsor, CT 06095-2545
Phone
(860) 246-7999
Fax
(860) 688-0004
NPI assigned
Dec 11, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
001421CTMDRegistered Respiratory Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001421 CT Yes

Addresses

Primary practice location

41 Mechanic St
Windsor, CT 06095-2545

Mailing address

30 Maple Ave
Windsor, CT 06095-2922
Phone (860) 246-7999

Other providers in Windsor, CT

All providers in Windsor, CT · Marriage & Family Therapist in Connecticut

Sources for this page

Verify at the official NPI Registry.