Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 002902 | CT |
Y | 103TC0700X | Clinical Psychologist | 002902 | CT |
NPI | 1003078890 |
---|---|
Provider Name | Dr. Alison Brodhagen |
First Address | New Haven, CT 06511-3933 |
Second Address | New Haven, CT 06511-3933 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2008 |
Last Update Date | 05/12/2008 |