Provider Information for 1104910801
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Ms. LAUREN A VERNAGLIA LCSW
Sex: Female
NPI: 1104910801
Last Updated: 2012-04-13
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1104910801 | ||||||||
| Enumeration Date | 2006-10-03 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 79 BEECHWOOD LANE BRISTOL, CT 06010 United States Phone: 860-585-5459 | Fax: | ||||||||
| Primary Practice Address | 693 BLOOMFIELD AVE BLOOMFIELD, CT 06002-2489 United States Phone: 860-243-6584 | Fax:860-243-6591 | ||||||||
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