Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 001700 | CT |
N | 103TC0700X | Clinical Psychologist | 001700 | CT |
N | 102L00000X | Psychologist | 001700 | CT |
N | 103T00000X | Psychologist | 001700 | CT |
NPI | 1003825191 |
---|---|
Provider Name | Dr. Jill Ramsey Edgar |
First Address | Stamford, CT 06905-1513 |
Second Address | Stamford, CT 06905-1513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 08/07/2007 |