Individual
MS. DIANE SAMUELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
12 N MAIN ST STE 10, WEST HARTFORD, CT 06107-1936
(869) 841-0169
Mailing address
29 PHEASANT CHASE, WEST HARTFORD, CT 06117
(860) 841-0169
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001410
CT
Other
Enumeration date
01/10/2011
Last updated
10/04/2011
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