Healthcare Provider Details

I. General information

NPI: 1316978000
Provider Name (Legal Business Name): TOWN OF GUILFORD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 GRAVES AVE
GUILFORD CT
06437-2626
US

IV. Provider business mailing address

36 GRAVES AVE
GUILFORD CT
06437-2626
US

V. Phone/Fax

Practice location:
  • Phone: 203-453-8047
  • Fax: 203-453-8044
Mailing address:
  • Phone: 203-453-8047
  • Fax: 203-453-8044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JUDY MILLER
Title or Position: INTERIM DIRECTOR
Credential:
Phone: 203-453-8047