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Individual

MR. JOSEPH MANCINONE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
271 SOUTHBURY RD, ROXBURY, CT 06783-2101
(203) 788-5119
Mailing address
271 SOUTHBURY RD, ROXBURY, CT 06783-2101

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
001202
CT

Other

Enumeration date
03/20/2015
Last updated
03/20/2015
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