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NPI 1689634693

NPI 1689634693 : CHRISTOPHER ROBERT DUMAS L.M.F.T. : MANCHESTER, CT

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General NPI Number Information
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    NPI Number           |    1689634693
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTOPHER ROBERT DUMAS L.M.F.T.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/24/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    71 HAYNES ST 
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    City                 |    MANCHESTER
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    State                |    CT
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    Zip                  |    06040-4131
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    Country              |    US
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    Telephone            |    860-646-1222
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    Fax                  |    860-533-3452
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Provider Business Mailing Address
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    Address Line         |    92 BOLTON STREET 
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    City                 |    MANCHESTER
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    State                |    CT
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    Zip                  |    06040
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    Country              |    US
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    Telephone            |    860-643-7460
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    000873
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    License Number State |    CT
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