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General NPI Number Information
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NPI Number | 1578052114
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Entity Type | Organization
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Legal Business Name | CARA LATTIZORI NGUYEN, PSY.D., LLC
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Dates
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Enumeration Date | 05/09/2018
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Last Update Date | 05/10/2018
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Provider Practice Location Address
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Address Line | 85 RIVER RD STE A
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City | COLLINSVILLE
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State | CT
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Zip | 06019-3245
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Country | US
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Telephone | 860-307-0379
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 735
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City | NEW HARTFORD
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State | CT
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Zip | 06057-0735
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Country | US
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Telephone | 860-307-0379
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. CARA SIENA NGUYEN
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Credential | PSY.D.
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Telephone | 860-307-0379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | 002940
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License Number State | CT
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