Most Relevant Information
Provider Data
| NPI Number: | 1003432733 |
| Provider Name: | MIA LALEH TABIB |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/18/2020 |
| Last Updated: | 06/18/2020 |
Provider Practice Location
13 SYCAMORE WAY
BRANFORD
CT
064056518
Practice Location Phone/Fax
| Phone: | 2034832645 |
| Fax: |
Provider Mailing Location
127 WASHINGTON AVE
NORTH HAVEN
CT
064731715
Provider Mailing Phone/Fax
| Phone: | 2034469739 |
| Fax: |