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General NPI Number Information
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NPI Number | 1942537212
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Entity Type | Organization
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Legal Business Name | G TODD MCDONALD APRN LLC
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Dates
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Enumeration Date | 11/07/2009
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Last Update Date | 11/07/2009
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Provider Practice Location Address
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Address Line | 400 WASHINGTON ST
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City | HARTFORD
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State | CT
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Zip | 06106-3351
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Country | US
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Telephone | 860-545-7229
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Fax | 860-545-7002
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Provider Business Mailing Address
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Address Line | 26 ELAINE MARY DR
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City | WINDSOR
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State | CT
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Zip | 06095-1717
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Country | US
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Telephone | 860-545-7229
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Fax | 860-545-7002
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Authorized Official
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Title or Position | OWNER
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Name | TODD MCDONALD
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Credential | APRN
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Telephone | 860-545-7229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 001698
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License Number State | CT
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