Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1083812440 |
---|---|
Provider Name | Dr. Alice M Forrester |
First Address | New Haven, CT 06515-1902 |
Second Address | New Haven, CT 06511-3933 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2007 |
Last Update Date | 08/07/2007 |