Individual
ALYSON FAIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
675 MAIN STREET, COMMUNITY HEALTH CENTER, MIDDLETOWN, CT 06457
(860) 347-6971
Mailing address
575 MAIN ST FL 2, MIDDLETOWN, CT 06457-2845
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4451
CT
Other
Enumeration date
03/31/2023
Last updated
03/31/2023
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