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NPI 1457498925

NPI 1457498925 : ANDREA F FLAHERTY LMFT : FARMINGTON, CT

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General NPI Number Information
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    NPI Number           |    1457498925
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    Entity Type          |    Individual 
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    Provider Name        |    ANDREA F FLAHERTY LMFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/31/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    263 FARMINGTON AVE 
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    City                 |    FARMINGTON
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    State                |    CT
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    Zip                  |    06032-1956
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    Country              |    US
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    Telephone            |    860-679-2435
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    Fax                  |    860-679-1699
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Provider Business Mailing Address
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    Address Line         |    745 CHERRY BROOK ROAD 
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    City                 |    CANTON
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    State                |    CT
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    Zip                  |    06019-5016
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    Country              |    US
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    Telephone            |    860-693-4098
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    Fax                  |    860-679-1699
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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       |    000799
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    License Number State |    CT
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