Healthcare Provider Details

I. General information

NPI: 1619100708
Provider Name (Legal Business Name): CHRISTINE DAUSER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2009
Last Update Date: 08/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 SOUTH FRONTAGE RD
NEW HAVEN CT
06520-7900
US

IV. Provider business mailing address

230 S FRONTAGE RD
NEW HAVEN CT
06519-1124
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-2513
  • Fax: 203-737-5455
Mailing address:
  • Phone: 203-785-2513
  • Fax: 203-737-5455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number002182
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: