Individual
MRS. MADELINE MANTILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
401 SHIPPAN AVE, STAMFORD, CT 06902-6075
(203) 517-3375
(203) 353-1524
Mailing address
180 FAIRFIELD AVE, BRIDGEPORT, CT 06604-4252
(203) 394-6529
(203) 384-8835
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
003667
CT
Other
Enumeration date
06/03/2015
Last updated
12/03/2019
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