Healthcare Provider Details

I. General information

NPI: 1649197484
Provider Name (Legal Business Name): ROSEMARIE LAFLEUR BACH PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HINMAN ST
CHESHIRE CT
06410-2546
US

IV. Provider business mailing address

100 HINMAN ST
CHESHIRE CT
06410-2546
US

V. Phone/Fax

Practice location:
  • Phone: 203-250-0305
  • Fax: 203-439-3510
Mailing address:
  • Phone: 203-250-0305
  • Fax: 203-439-3510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2403
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: