Doctor Name: | ROBERT G SUTTON |
NPI Number: | 1073532917 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 001165 |
Business Practice Address: | 55 Nye Rd Glastonbury, CT - 060331281 |
Business Phone Number: | 8605214788 |
Business Fax Number: | |
Mailing Address: | 20 Race Brook Rd, WEST HARTFORD |
State: | CT |
Postal Code: | 061073110 |
Phone Number: | 8605214788 |
Fax Number: | |
NPI Enumeration Date: | 07/19/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 001165 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |