Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 002963 | CT |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 002963 | CT |
Y | 103G00000X | Clinical Psychologist | 002963 | CT |
Y | 103TC0700X | Clinical Psychologist | 002963 | CT |
N | 103TC1900X | Counseling Psychologist | 002963 | CT |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 002963 | CT |
N | 103TP2701X | Group Psychotherapist | 002963 | CT |
NPI | 1194875294 |
---|---|
Provider Name | Dr. Mary-Margaret Ellen Freier |
First Address | Glastonbury, CT 06033-1077 |
Second Address | Colchester, CT 06415 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 02/12/2009 |