Abigail Wallman

Individual provider Active NPI Clinical Psychologist · West Simsbury, CT

NPI 1154622256 · NPPES record last updated Oct 13, 2024

Key facts

NPI
1154622256
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
4807 (CT)
Practice address
30 Meadowlark Rd
West Simsbury, CT 06092-2418
Phone
(845) 863-9011
NPI assigned
Nov 5, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4807 CT Yes

Addresses

Primary practice location

30 Meadowlark Rd
West Simsbury, CT 06092-2418

Mailing address

30 Meadowlark Rd
West Simsbury, CT 06092-2418
Phone (845) 863-9011

Other providers in West Simsbury, CT

All providers in West Simsbury, CT · Clinical Psychologist in Connecticut

Sources for this page

Verify at the official NPI Registry.