Individual
MS. MICHELLE LEE DICORPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, MFT
Contact information
Practice address
769 NEWFIELD ST STE 2, MIDDLETOWN, CT 06457-1846
(860) 965-4072
Mailing address
769 NEWFIELD ST STE 2, MIDDLETOWN, CT 06457-1846
(860) 965-4072
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008001149
—
CT
Enumeration date
05/19/2013
Last updated
06/19/2014
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