Individual
SAMANTHA MICAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 WEST CENTER STREET, SUITE C-2-6, MANCHESTER, CT 06040
(860) 793-7263
Mailing address
91 NORTHWEST DR, PLAINVILLE, CT 06062-1534
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
06/06/2016
Last updated
12/18/2017
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