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General NPI Number Information
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NPI Number | 1508061466
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Entity Type | Organization
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Legal Business Name | RHODA L KREISMAN PH D
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 09/11/2014
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Provider Practice Location Address
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Address Line | 393 CENTER ST
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City | WALLINGFORD
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State | CT
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Zip | 06492-4206
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Country | US
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Telephone | 203-265-4036
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Fax | 203-284-8302
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Provider Business Mailing Address
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Address Line | 393 CENTER ST
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City | WALLINGFORD
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State | CT
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Zip | 06492-4206
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Country | US
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Telephone | 203-265-4036
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Fax | 203-284-8302
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RHODA L KREISMAN
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Credential | PH. D LICENSED PSYCH
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Telephone | 203-265-4036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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