Healthcare Provider Details

I. General information

NPI: 1952234015
Provider Name (Legal Business Name): KAMELLANN MACALOU-DRAME
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 HARTFORD TPKE STE 106
VERNON CT
06066-4760
US

IV. Provider business mailing address

281 HARTFORD TPKE STE 106
VERNON CT
06066-4760
US

V. Phone/Fax

Practice location:
  • Phone: 860-494-3800
  • Fax:
Mailing address:
  • Phone: 860-494-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number3773
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: