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General NPI Number Information
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NPI Number | 1265922249
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Entity Type | Organization
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Legal Business Name | PHYLLIS L. WEIHS-YAVNER, PC
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Dates
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Enumeration Date | 05/15/2018
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Last Update Date | 05/15/2018
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Provider Practice Location Address
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Address Line | 30 OLD KINGS HWY S # 1
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City | DARIEN
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State | CT
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Zip | 06820-4551
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Country | US
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Telephone | 203-858-9550
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Fax |
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Provider Business Mailing Address
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Address Line | 30 OLD KINGS HWY S # 1
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City | DARIEN
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State | CT
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Zip | 06820-4551
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Country | US
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Telephone | 203-858-9550
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. PHYLLIS L WEIHS-YAVNER
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Credential | LPC
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Telephone | 203-858-9550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 002535
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License Number State | CT
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