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General NPI Number Information
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NPI Number | 1407993579
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Entity Type | Individual
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Provider Name | KRISTI A SACCO PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 191 POST RD W
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City | WESTPORT
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State | CT
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Zip | 06880-4625
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Country | US
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Telephone | 203-767-0366
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Fax | 267-316-7428
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Provider Business Mailing Address
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Address Line | 11 OLD OAK RD
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City | TRUMBULL
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State | CT
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Zip | 06611-1830
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Country | US
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Telephone | 203-767-0366
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Fax | 267-316-7428
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 002537
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License Number State | CT
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