Individual
EMMANUEL SILVA DE SOUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
675 MAIN STREET, MIDDLETOWN, CT 06457
(860) 347-6971
Mailing address
250 GWEN RD, SOUTHINGTON, CT 06489-4201
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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