Individual
MRS. SAMANTHA ANNE BOUTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 N MAIN ST STE 305, WEST HARTFORD, CT 06107-1901
(203) 240-7075
Mailing address
10 N MAIN ST STE 305, WEST HARTFORD, CT 06107-1901
(203) 240-7075
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
46.003996
CT
Other
Enumeration date
11/15/2019
Last updated
01/24/2020
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