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General NPI Number Information
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NPI Number | 1245955020
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Entity Type | Organization
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Legal Business Name | JENNIFER ESPINOZA PSYD LLC
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Dates
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Enumeration Date | 10/05/2022
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 642 HILLIARD ST
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City | MANCHESTER
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State | CT
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Zip | 06042-2701
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Country | US
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Telephone | 860-783-8852
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Fax |
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Provider Business Mailing Address
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Address Line | 47 CIDER BROOK DR
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City | WETHERSFIELD
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State | CT
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Zip | 06109-3263
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Country | US
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Telephone | 860-638-8518
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | JENNIFER ESPINOZA
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Credential | PSYD
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Telephone | 860-638-8518
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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