Healthcare Provider Details

I. General information

NPI: 1992316384
Provider Name (Legal Business Name): YVETTE VARGAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2020
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date: 07/18/2023
Reactivation Date: 08/02/2023

III. Provider practice location address

36 MILL PLAIN RD STE 312B
DANBURY CT
06811-5114
US

IV. Provider business mailing address

36 MILL PLAIN RD STE 312B
DANBURY CT
06811-5114
US

V. Phone/Fax

Practice location:
  • Phone: 203-947-3210
  • Fax:
Mailing address:
  • Phone: 203-947-3210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1519
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: