Graduated: 2007
NPI: 1881832327
Practice Locations (2)
STATE OF CONNECTICUT
263 FARMINGTON AVE
FARMINGTON, CT 060300001
8606792000
STATE OF CONNECTICUT
55 W MAIN ST, 410 WESTERN CONNECTICUT MENTAL HEALTH N
WATERBURY, CT 067025524
2038056414
Source: CMS National Downloadable File, September 2026.