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General NPI Number Information
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NPI Number | 1629774450
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Entity Type | Organization
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Legal Business Name | ALICIA ANN MACDOUGALL PSYD PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 02/02/2023
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 336 LAUREL ST
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City | EAST HAVEN
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State | CT
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Zip | 06512-1514
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Country | US
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Telephone | 203-215-9718
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Fax |
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Provider Business Mailing Address
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Address Line | 800 VILLAGE WALK # 195
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City | GUILFORD
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State | CT
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Zip | 06437-2762
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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 | PSYCHOLOGIST
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Name | DR. ALICIA ANN MACDOUGALL
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Credential | PSY.D.
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Telephone | 203-215-9718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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