Individual
ANDREA T COYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5A SUNSET AVE., PUTNAM, CT 06260
(860) 928-2119
(860) 928-4079
Mailing address
P.O. BOX 158, WOODSTOCK, CT 06281
(860) 928-2119
(860) 928-4079
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
001513
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004094497
—
CT
Enumeration date
09/13/2006
Last updated
03/11/2009
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