Individual
COLLEEN WALLACE MASTROIANNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
287 MAIN ST, EAST HARTFORD, CT 06118-1885
(860) 569-5900
Mailing address
148 FOREST RD, COVENTRY, CT 06238-2922
(860) 977-1903
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3701
CT
Other
Enumeration date
03/21/2019
Last updated
03/21/2019
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