Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 103K00000X | Behavior Analyst |
NPI | 1013361542 |
---|---|
Provider Name | Nicole Mcminn |
First Address | Cheshire, CT 06410-3428 |
Second Address | Middletown, CT 06457-1870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2016 |
Last Update Date | 21/04/2016 |