| Doctor Name: | DR. MICHELLE NITTO LEVEILLE |
| NPI Number: | 1184604381 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 002454 |
| Business Practice Address: | 750 Old Main St Suite 306 Rocky Hill, CT - 060671567 |
| Business Phone Number: | 8605247538 |
| Business Fax Number: | |
| Mailing Address: | 97 Whittlesey Rd, WOODBURY |
| State: | CT |
| Postal Code: | 067982535 |
| Phone Number: | 2035101494 |
| Fax Number: | 2035737007 |
| NPI Enumeration Date: | 01/23/2006 |
| NPI Last Update Date: | 01/02/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 002454 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |