Doctor Name: | MELODY WYSOCKI |
NPI Number: | 1083013387 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | |
Business Practice Address: | 55 Winthrop St New Britain, CT - 060521728 |
Business Phone Number: | 8602248192 |
Business Fax Number: | |
Mailing Address: | 55 Winthrop St, NEW BRITAIN |
State: | CT |
Postal Code: | 060521728 |
Phone Number: | 8602248192 |
Fax Number: | |
NPI Enumeration Date: | 08/22/2014 |
NPI Last Update Date: | 08/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |