Individual
HOLLY MARINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, LADC, RN
Contact information
Practice address
949 BRIDGEPORT AVE, MILFORD, CT 06460-3142
(203) 878-6365
Mailing address
949 BRIDGEPORT AVE, MILFORD, CT 06460-3142
(203) 878-6365
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000579
CT
163W00000X
Registered Nurse
R29021
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
001492
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000254423
UNITED BEHAVIORAL HEALTH
CT
05
—
004039244
—
CT
01
—
235142
COMPSYCH
CT
01
—
311160
HEALTHNET/MHN
—
01
—
400001492CT03
ANTHEM
CT
01
—
P00098065
RAILROAD MEDICARE
CT
Enumeration date
07/18/2006
Last updated
10/13/2010
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