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General NPI Number Information
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NPI Number | 1477059244
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Entity Type | Individual
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Provider Name | KATHRYN GIUSEPPONE PHD
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Gender | Female
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 02/16/2021
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Provider Practice Location Address
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Address Line | 230 S FRONTAGE RD
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City | NEW HAVEN
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State | CT
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Zip | 06519-1124
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Country | US
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Telephone | 203-785-4386
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Fax |
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Provider Business Mailing Address
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Address Line | 350 GEORGE ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-6617
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Country | US
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Telephone |
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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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 | 003937
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License Number State | CT
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