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General NPI Number Information
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NPI Number | 1821394925
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Entity Type | Organization
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Legal Business Name | MARIA GUGLIELMINO, PSY.D., LLC
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Dates
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Enumeration Date | 02/07/2011
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Last Update Date | 02/07/2011
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Provider Practice Location Address
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Address Line | 40 MAIN ST N SUITE 2-F
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City | WOODBURY
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State | CT
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Zip | 06798-2966
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Country | US
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Telephone | 203-266-9253
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Fax |
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Provider Business Mailing Address
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Address Line | P. O. BOX 39
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City | WOODBURY
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State | CT
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Zip | 06798
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Country | US
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Telephone | 203-266-9253
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. MARIA J. GUGLIELMINO
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Credential | PSY.D.
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Telephone | 203-266-9253
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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 | 002622
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License Number State | CT
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