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1295450070
MICAH SW WOLF
DANIELSON, CT
NPI
1295450070
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2022-10-05
Last Update Date
2022-10-05
Business Address
MICAH SW WOLF
71 WESTCOTT RD
DANIELSON, CT 06239-2929
Phone number: 860-774-7179
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Mailing Address
MICAH SW WOLF
2 WATERSIDE XING STE 401
WINDSOR, CT 06095-1588
Phone number: 860-697-3351
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