Individual
DR. MARVIN HUGH DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
330 MARKET ST, HARTFORD, CT 06120-2901
(860) 490-8864
(860) 761-7928
Mailing address
34 LINCOLN TER, BLOOMFIELD, CT 06002-3125
(860) 830-9333
(860) 761-7928
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000090
CT
Other
Enumeration date
12/05/2013
Last updated
12/05/2013
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