Individual
MARK WILLIAM AUGUSTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
70 PINE ST, WATERBURY, CT 06710-2169
(203) 756-7287
(203) 596-2789
Mailing address
70 PINE ST, WATERBURY, CT 06710-2169
(203) 756-7287
(203) 596-2789
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
CT000994
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004242327
—
CT
Enumeration date
11/02/2006
Last updated
02/18/2014
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