Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 002169 | CT |
Y | 103T00000X | Psychologist | 002169 | CT |
NPI | 1003976614 |
---|---|
Provider Name | Kathleen A Chapman |
First Address | Middletown, CT 06457 |
Second Address | Middletown, CT 06457 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 27/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
680001537 | MEDICARE PRIVATE PRACTICE (01) |