Individual
MS. MICHELLE R. WILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1 GRIST MILL LN, SIMSBURY, CT 06070-2485
(860) 325-2176
Mailing address
31 FIRETOWN RD, WEST GRANBY, CT 06090-1612
(860) 325-2176
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2016
CT
Other
Enumeration date
03/28/2011
Last updated
03/28/2011
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