Graduated: 1989
NPI: 1306925284
Practice Locations (2)
STATE OF CONNECTICUT
1000 SILVER ST
MIDDLETOWN, CT 064573940
8602625200
STATE OF CONNECTICUT
55 W MAIN ST, 410 WESTERN CONNECTICUT MENTAL HEALTH N
WATERBURY, CT 067025524
2038056414
Source: CMS National Downloadable File, September 2026.