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Individual

MARK NASSAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A. PSY

Contact information

Practice address
23 BURNHAM ST, ENFIELD, CT 06082-6144
(860) 543-9775
Mailing address
23 BURNHAM ST, ENFIELD, CT 06082-6144

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YS0200X
School Counselor

Other

Enumeration date
11/08/2013
Last updated
11/08/2013
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