Vayalakkara, Jyothi
Vayalakkara, Jyothi is an individual health care provider with primary practice located at 152 Deming St Providercare Plus, Pc, South Windsor CT 06074-3740. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is her primary health care specialty. Vayalakkara, Jyothi can be contacted via phone (860) 644-4472.Contact Information
Primary practice address
152 Deming St Providercare Plus, Pc
South Windsor CT 06074-3740
Phone: (860) 644-4472
Fax: (860) 644-3001
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 002590 | Connecticut |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 002590 | Connecticut |
Profile Details
| NPI number | 1558449660 |
|---|---|
| LBN Legal business name | Vayalakkara, Jyothi |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 2nd, 2006 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558449660 | NPPES |
| Connecticut | Other | 060002590CT01 | ANTHEM BCBS |
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