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Individual

DR. MICHAEL VINCENT PANTALON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
234 CHURCH ST, SUITE 301, NEW HAVEN, CT 06510-1804
(203) 506-3134
(203) 244-4239
Mailing address
234 CHURCH ST, SUITE 301, NEW HAVEN, CT 06510-1804
(203) 506-3134
(203) 244-4239

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
002123
CT
103TA0400X
Addiction (Substance Use Disorder) Psychologist
002123
CT

Other

Enumeration date
11/06/2009
Last updated
11/06/2009
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