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Individual

NICOLE MCMINN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MFT

Contact information

Practice address
20 TUTTLE PL, MIDDLETOWN, CT 06457-1870
(860) 632-3235
Mailing address
189 MANSION RD, CHESHIRE, CT 06410-3428
(203) 584-6373

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
103K00000X
Behavior Analyst
106H00000X
Marriage & Family Therapist
Primary

Other

Enumeration date
04/21/2016
Last updated
04/21/2016
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