Individual
MICHAEL HEAVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 BLUE HILLS AVE, APT B2, HARTFORD, CT 06112-1254
(860) 242-0848
Mailing address
601 BLUE HILLS AVE, APT B2, HARTFORD, CT 06112-1254
(860) 242-0848
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/03/2017
Last updated
02/03/2017
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