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NPI 1336205061

NPI 1336205061 : ROSEMARIE CORATOLA PSY.D., LMFT : NEW HAVEN, CT

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General NPI Number Information
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    NPI Number           |    1336205061
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    Entity Type          |    Individual 
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    Provider Name        |    ROSEMARIE CORATOLA PSY.D., LMFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/28/2006
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    Last Update Date     |    01/25/2012
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Provider Practice Location Address
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    Address Line         |    240 BRADLEY ST 
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    City                 |    NEW HAVEN
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    State                |    CT
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    Zip                  |    06510-1108
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    Country              |    US
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    Telephone            |    203-605-6243
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    240 BRADLEY ST 
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    City                 |    NEW HAVEN
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    State                |    CT
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    Zip                  |    06510-1108
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    Country              |    US
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    Telephone            |    203-605-6243
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    000495
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    License Number State |    CT
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Taxonomy #2
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    Taxonomy Code        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    003054
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    License Number State |    CT
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