| River Valley Neuropsychology Llc | |
|
322 Main St Ste 2e-10 Willimantic CT 06226-3152 | |
| (860) 230-8851 | |
| (860) 812-2317 |
| Full Name | River Valley Neuropsychology Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 322 Main St Ste 2e-10, Willimantic, Connecticut |
| Authorized Official Name and Position | Sarah E Bullard (PHD) |
| Authorized Official Contact | 8602308851 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| River Valley Neuropsychology Llc 234 Gurleyville Rd Storrs CT 06268-1416 Ph: (860) 230-8851 | River Valley Neuropsychology Llc 322 Main St Ste 2e-10 Willimantic CT 06226-3152 Ph: (860) 230-8851 |
| NPI Number | 1295194546 |
|---|---|
| Provider Enumeration Date | 02/15/2016 |
| Last Update Date | 02/15/2016 |
| Medicare PECOS PAC ID | 1951608603 |
|---|---|
| Medicare Enrollment ID | O20160324001038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295194546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 0002504 (Connecticut) | Primary |
| Provider Name | Sarah E Bullard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417963596 PECOS PAC ID: 2163312265 Enrollment ID: I20040319000825 |
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