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NPI 1851485619

NPI 1851485619 : ROBIN A. GRANT-HALL PH.D. : GLASTONBURY, CT

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General NPI Number Information
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    NPI Number           |    1851485619
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    Entity Type          |    Individual 
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    Provider Name        |    ROBIN A. GRANT-HALL PH.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/03/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    19 CONCORD ST 
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    City                 |    GLASTONBURY
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    State                |    CT
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    Zip                  |    06033-2135
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    Country              |    US
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    Telephone            |    860-659-8765
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    Fax                  |    860-652-8584
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Provider Business Mailing Address
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    Address Line         |    19 CONCORD ST 
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    City                 |    GLASTONBURY
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    State                |    CT
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    Zip                  |    06033-2135
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    Country              |    US
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    Telephone            |    860-659-8765
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    Fax                  |    860-652-8584
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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        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    001578
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    License Number State |    CT
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