Individual provider · Type 1 NPI

Emily Bronson Forman

Mental Health Counselor · Middletown, CT

NPI number 1104372879 Active

Practice location

230 Main Street Ext
Middletown, CT 06457-4470

Call (860) 343-5303 Map

Mailing address

230 Main Street Extension P.0. Box 1000
Middletown, CT 06457

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1104372879

Emily Bronson Forman's National Provider Identifier is 1104372879, issued on Aug 31, 2016. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Middletown, CT. The record was last updated on Aug 31, 2016.