Doctor Name: | ALIX MURY |
NPI Number: | 1235584137 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2904 |
Business Practice Address: | 18 Birch Rd Rocky Hill, CT - 060673702 |
Business Phone Number: | 9852871475 |
Business Fax Number: | |
Mailing Address: | 18 Birch Rd, ROCKY HILL |
State: | CT |
Postal Code: | 060673702 |
Phone Number: | 9852871475 |
Fax Number: | |
NPI Enumeration Date: | 04/28/2016 |
NPI Last Update Date: | 04/28/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2904 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |