Organization
J. RANDOLPH BURNHAM PH.D.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
J. RANDOLPH BURNHAM PH.D. (PRESIDENT)
(203) 227-7199
Entity
Organization
Contact information
Practice address
18 KINGS HWY S, WESTPORT, CT 06880-4710
(203) 227-7199
Mailing address
18 KINGS HWY S, WESTPORT, CT 06880-4710
(203) 227-7199
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
464
CT
Other
Enumeration date
01/10/2007
Last updated
08/22/2020
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