Individual
ANTHONY AUGUSTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
841 MIDDLESEX TPKE, OLD SAYBROOK, CT 06475-1317
(860) 395-0111
(860) 395-1264
Mailing address
841 MIDDLESEX TPKE, OLD SAYBROOK, CT 06475-1317
(860) 395-0111
(860) 395-1264
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000884
CT
Other
Enumeration date
10/26/2009
Last updated
10/26/2009
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