Healthcare Provider Details

I. General information

NPI: 1871656397
Provider Name (Legal Business Name): JENNIFER DENKIN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 09/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 SAND PIT RD SUITE 300
DANBURY CT
06810-4004
US

IV. Provider business mailing address

69 SAND PIT RD SUITE 300
DANBURY CT
06810-4004
US

V. Phone/Fax

Practice location:
  • Phone: 203-748-2551
  • Fax: 203-790-6375
Mailing address:
  • Phone: 203-748-2551
  • Fax: 203-790-6375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number003019
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number003019
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number003019
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: