Individual
NICOLE WALLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
162 WEST ST STE F, CROMWELL, CT 06416-4405
(860) 613-9930
(860) 613-9952
Mailing address
162 WEST ST STE F, CROMWELL, CT 06416-4405
(860) 613-9930
(860) 613-9952
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
CT
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
12/22/2017
Last updated
10/18/2019
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