Organization
DANIEL R BROCKETT PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL R. BROCKETT PH.D. (OWNER)
(203) 264-3050
Entity
Organization
Contact information
Practice address
2 POMPERAUG OFFICE PARK, SUITE 206D, SOUTHBURY, CT 06488-2288
(203) 264-3050
(203) 264-2426
Mailing address
2 POMPERAUG OFFICE PARK, SUITE 206D, SOUTHBURY, CT 06488-2288
(203) 264-3050
(203) 264-2426
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
001851
CT
Other
Enumeration date
04/19/2012
Last updated
09/17/2012
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