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General NPI Number Information
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NPI Number | 1376875633
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Entity Type | Individual
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Provider Name | MICHELLE DAYNA ALLISON LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/10/2010
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Last Update Date | 06/23/2016
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Provider Practice Location Address
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Address Line | 638 BROWNS RD
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City | STORRS MANSFIELD
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State | CT
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Zip | 06268-2717
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Country | US
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Telephone | 860-933-5072
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Fax | 860-456-3482
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Provider Business Mailing Address
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Address Line | 638 BROWNS RD
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City | STORRS MANSFIELD
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State | CT
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Zip | 06268-2717
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Country | US
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Telephone | 860-933-5072
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Fax | 860-456-3482
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 000436
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License Number State | CT
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