Provider Information for 1013361542
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NICOLE MCMINN MFT
Other Names:Former Name:NICOLE SICIGNANOSex: Female
NPI: 1013361542
Last Updated: 2016-04-21
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1013361542 | ||||||||||||||||||||
| Enumeration Date | 2016-04-21 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 189 MANSION RD CHESHIRE, CT 06410-3428 United States Phone: 203-584-6373 | Fax: | ||||||||||||||||||||
| Primary Practice Address | 20 TUTTLE PL MIDDLETOWN, CT 06457-1870 United States Phone: 860-632-3235 | Fax: | ||||||||||||||||||||
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