Doctor Name: | DR. SUZANNE CIARAMELLA |
NPI Number: | 1154476778 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSYD |
License Number: | 002467 |
Business Practice Address: | 6 Storrs Rd Suite #3 Mansfield Center, CT - 06250 |
Business Phone Number: | 8604236572 |
Business Fax Number: | |
Mailing Address: | 67 Scotland Rd, WINDHAM |
State: | CT |
Postal Code: | 062801219 |
Phone Number: | 8609164253 |
Fax Number: | |
NPI Enumeration Date: | 01/24/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 002467 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |