Individual
MICHAEL MUTART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
585 HAZARD AVE, ENFIELD, CT 06082-4241
(413) 237-2973
Mailing address
36 SAINT JAMES AVE, ENFIELD, CT 06082-3048
(413) 237-2973
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4326
MA
101YP2500X
Professional Counselor
Primary
002712
CT
Other
Enumeration date
03/30/2015
Last updated
03/30/2015
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