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General NPI Number Information
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NPI Number | 1457709818
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Entity Type | Organization
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Legal Business Name | BARBARA A. MOYNIHAN LLC
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Dates
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Enumeration Date | 05/26/2016
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 1 S MAIN ST
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City | BRANFORD
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State | CT
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Zip | 06405-3872
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Country | US
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Telephone | 888-616-8536
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 194
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City | BRANFORD
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State | CT
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Zip | 06405-0194
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BARBARA A MOYNIHAN
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Credential |
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Telephone | 888-616-8536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number | 001038
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License Number State | CT
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