Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 003429 | CT |
Y | 103TC0700X | Clinical Psychologist | 003429 | CT |
N | 103TS0200X | School Psychologist | 438546 | MA |
NPI | 1093725848 |
---|---|
Provider Name | Mrs. Ellen Marie Galat |
First Address | Ellington, CT 06029-4160 |
Second Address | Ellington, CT 06029-4160 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 22/12/2014 |