Provider Demographics
NPI:1518277730
Name:WATERHOUSE, DARREN M
Entity Type:Individual
Prefix:MR
First Name:DARREN
Middle Name:M
Last Name:WATERHOUSE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 ELAINE MARY DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-1714
Mailing Address - Country:US
Mailing Address - Phone:860-559-7715
Mailing Address - Fax:
Practice Address - Street 1:50 GRISWOLD ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-2008
Practice Address - Country:US
Practice Address - Phone:860-224-5267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional