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General NPI Number Information
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NPI Number | 1538989660
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Entity Type | Organization
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Legal Business Name | PSYCHIATRY & BEHAVIORAL HEALTH SERVICES PLLC
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 425 MAIN ST
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City | MIDDLETOWN
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State | CT
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Zip | 06457-3376
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Country | US
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Telephone | 347-484-1044
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Fax |
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Provider Business Mailing Address
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Address Line | 300 OLD MILL RD
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City | MIDDLETOWN
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State | CT
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Zip | 06457-2453
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Country | US
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Telephone | 347-484-1044
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Fax |
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Authorized Official
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Title or Position | NP
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Name | EUNICE DOE DUNU
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Credential | PMHNP
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Telephone | 347-484-1044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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