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General NPI Number Information
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NPI Number | 1316568660
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Entity Type | Organization
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Legal Business Name | MINDFUL CONNECTIONS PSYCHOTHERAPY, PLLC
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Dates
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Enumeration Date | 04/28/2020
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Last Update Date | 06/12/2020
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Provider Practice Location Address
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Address Line | 151 NEW PARK AVENUE SUITE 117
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City | HARTFORD
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State | CT
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Zip | 06106-2170
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Country | US
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Telephone | 407-913-4396
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Fax |
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Provider Business Mailing Address
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Address Line | 151 NEW PARK AVENUE SUITE 117
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City | HARTFORD
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State | CT
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Zip | 06106-2152
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Country | US
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Telephone | 407-913-4396
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | ANGELICA VALENTIN-COLON
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Credential | PSY.D.
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Telephone | 407-913-4396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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