Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 002597 | CT |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 014819 | NY |
N | 103TF0000X | Family Psychologist | 002597 | CT |
N | 103TP2701X | Group Psychotherapist | 002597 | CT |
N | 103TS0200X | School Psychologist | 002597 | CT |
NPI | 1053770982 |
---|---|
Provider Name | Dr. Lori Attanasio Woodring |
First Address | Old Greenwich, CT 06870-2318 |
Second Address | Old Greenwich, CT 06870-2318 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2016 |
Last Update Date | 20/02/2016 |