MICHAEL JOHN FORMICA

GROTON, CT
NPI1174688311
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: CT  000869)
Enumeration Date2006-12-27
Last Update Date2007-07-08
Business Address
-- MICHAEL JOHN FORMICA LPC
616 GOLD STAR HWY
GROTON, CT 06340-6221
Phone number: 860-449-0200
Mailing Address
-- MICHAEL JOHN FORMICA LPC
32 SEA CREST AVE
NIANTIC, CT 06357-3808
Phone number: 203-912-7218
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