Individual
MR. AVERY MICHAEL SAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
11 SYCAMORE WAY, BRANFORD, CT 06405-6552
(203) 800-7177
Mailing address
11 SYCAMORE WAY, BRANFORD, CT 06405-6552
(120) 392-7676
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9147
CT
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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