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Individual

MR. MATTHEW J BASTIAANSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
29 WINDHAM RD, BRISTOL, CT 06010
(860) 261-5367
(860) 261-5367
Mailing address
29 WINDHAM RD, BRISTOL, CT 06010
(860) 261-5367
(860) 261-5367

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001281
CT

Other

Enumeration date
08/13/2009
Last updated
02/24/2023
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