Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1043529894 |
---|---|
Provider Name | Sara Joy Schoonover |
First Address | Windsor, CT 06095-2947 |
Second Address | Bristol, CT 06010-4924 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2010 |
Last Update Date | 28/09/2010 |