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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.