Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 002409 | CT |
Y | 103TC0700X | Clinical Psychologist | 002409 | CT |
NPI | 1013012962 |
---|---|
Provider Name | Dr. Judith R. Silberkleit |
First Address | Stratford, CT 06614 |
Second Address | Stratford, CT 06615-6339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 10/11/2007 |