Provider Demographics
NPI:1629496146
Name:VIALL, ANNETTE (MSW)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:
Last Name:VIALL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 VINEGAR HILL RD
Mailing Address - Street 2:
Mailing Address - City:GALES FERRY
Mailing Address - State:CT
Mailing Address - Zip Code:06335-1715
Mailing Address - Country:US
Mailing Address - Phone:860-464-1108
Mailing Address - Fax:
Practice Address - Street 1:331 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-5836
Practice Address - Country:US
Practice Address - Phone:860-464-1108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker