Provider Demographics
NPI:1225061245
Name:WETSTONE, BARBARA (LADC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:WETSTONE
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06118-1883
Mailing Address - Country:US
Mailing Address - Phone:860-569-5900
Mailing Address - Fax:860-895-2328
Practice Address - Street 1:281 MAIN STREET
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06118-1883
Practice Address - Country:US
Practice Address - Phone:860-569-5900
Practice Address - Fax:860-895-2328
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000463101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
2182790OtherCIGNA BEHAVIORAL