Individual
MICAH J MANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LADC
Contact information
Practice address
434 PROSPECT ST, TORRINGTON, CT 06790-4937
(860) 877-4320
Mailing address
37 BRIDLE DR, BARKHAMSTED, CT 06063-3425
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
689
CT
Other
Enumeration date
04/27/2012
Last updated
04/27/2012
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