Individual
NILES WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 TUTTLE PL STE 4, MIDDLETOWN, CT 06457-1870
(860) 709-5672
Mailing address
554 PROSPECT AVE, HARTFORD, CT 06105-2920
(860) 709-5672
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/30/2023
Last updated
05/30/2023
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