Individual
DR. KELLY TAHANEY WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
300 HEBRON AVENUE, SUITE 217 MEDICAL ARTS CENTER COUNSELING AFFILIATES, GLASTONBURY, CT 06033
(860) 659-2697
(860) 659-3468
Mailing address
174 N QUAKER LANE, WEST HARTFORD, CT 06119
(860) 236-1695
(860) 236-1695
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
002358
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11518434
CAQH
—
Enumeration date
11/10/2006
Last updated
07/08/2007
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