| Richard L. Duvall, Ph.d, Llc | |
|
1420 Main St Suite 201 Glastonbury CT 06033-3110 | |
| (860) 633-9491 | |
| (860) 633-9491 |
| Full Name | Richard L. Duvall, Ph.d, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1420 Main St, Glastonbury, Connecticut |
| Authorized Official Name and Position | Richard Leigh Duvall (OWNER) |
| Authorized Official Contact | 8606339491 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard L. Duvall, Ph.d, Llc 1420 Main St Suite 201 Glastonbury CT 06033-3110 Ph: (860) 633-9491 | Richard L. Duvall, Ph.d, Llc 1420 Main St Suite 201 Glastonbury CT 06033-3110 Ph: (860) 633-9491 |
| NPI Number | 1447389762 |
|---|---|
| Provider Enumeration Date | 03/04/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0941468896 |
|---|---|
| Medicare Enrollment ID | O20120223000006 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447389762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1147 (Connecticut) | Primary |
| Provider Name | Richard L Duvall |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407985716 PECOS PAC ID: 2668630518 Enrollment ID: I20120223000021 |
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