Michael Fortin
Counselor in Manchester, CT. Individual provider (NPI-1).
NPI number1982114179
StatusActive
Last updated in NPPESOct 3, 2017
Details
- NPI
- 1982114179
- Entity type
- Individual (NPI-1)
- Name
- Michael Fortin
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 3, 2017
- Last updated
- Oct 3, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
444 Center StManchester, CT 06040-3926
Phone 860-243-6584 · Fax 860-243-6591
Mailing address
995 Day Hill RdWindsor, CT 06095-1722
Phone 860-731-5522 · Fax 860-731-5536
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