Healthcare Provider Details

I. General information

NPI: 1568144905
Provider Name (Legal Business Name): MELODY ATKINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2023
Last Update Date: 08/04/2023
Certification Date: 08/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 FARMINGTON AVE
WEST HARTFORD CT
06119-1600
US

IV. Provider business mailing address

801 FARMINGTON AVE
WEST HARTFORD CT
06119-1600
US

V. Phone/Fax

Practice location:
  • Phone: 203-733-9600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: