Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103G00000X | Clinical Psychologist | 019875 | CT |
N | 103TC0700X | Clinical Psychologist | 019875 | CT |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0000X | Family Psychologist |
NPI | 1457553513 |
---|---|
Provider Name | Dr. Hansa H Shah |
First Address | Bridgeport, CT 06610-2865 |
Second Address | Bridgeport, CT 06610-2865 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 26/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004052023 | (05) | CT |
004188282 | (05) | CT |
004191962 | (05) | CT |
004238764 | (05) | CT |
004258366 | (05) | CT |
004258374 | (05) | CT |
004259025 | (05) | CT |