Healthcare Provider Details

I. General information

NPI: 1164870200
Provider Name (Legal Business Name): KRISTIN ALLARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2016
Last Update Date: 03/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 WESTCOTT RD
DANIELSON CT
06239
US

IV. Provider business mailing address

995 DAY HILL RD
WINDSOR CT
06095-1722
US

V. Phone/Fax

Practice location:
  • Phone: 860-774-7179
  • Fax: 860-779-6526
Mailing address:
  • Phone: 860-731-5522
  • Fax: 860-731-5536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: