Individual
MR. MARCUS LEE CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
91 NORTHWEST DR, PLAINVILLE, CT 06062-1534
(860) 793-4200
Mailing address
91 NORTHWEST DR, PLAINVILLE, CT 06062-1534
(860) 793-4200
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/05/2014
Last updated
09/24/2015
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