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Organization

AVON SIMSBURY PSYCHOTHERAPY, LLC

Active
Other names
Simsbury Psychotherapy, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SARAH J GAMBLE PH.D. (OWNER)
(860) 989-7687
Entity
Organization

Contact information

Practice address
111 SIMSBURY RD, AVON, CT 06001-3763
(860) 989-7687
Mailing address
111 SIMSBURY RD, AVON, CT 06001-3763
(860) 989-7687

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1811
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
680001804
MEDICARE IDENTIFICATION NUMBER
CT
Enumeration date
03/06/2014
Last updated
03/06/2014
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