| Adult And Adolescent Psychological Services, Llc | |
|
78 Eastern Blvd Suite 4 Glastonbury CT 06033-4325 | |
| (860) 633-7882 | |
| (860) 659-1999 |
| Full Name | Adult And Adolescent Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 78 Eastern Blvd, Glastonbury, Connecticut |
| Authorized Official Name and Position | Pamela Deiter-sands (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 8606337882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adult And Adolescent Psychological Services, Llc 78 Eastern Blvd Glastonbury CT 06033-4325 Ph: (860) 633-7882 | Adult And Adolescent Psychological Services, Llc 78 Eastern Blvd Suite 4 Glastonbury CT 06033-4325 Ph: (860) 633-7882 |
| NPI Number | 1598707952 |
|---|---|
| Provider Enumeration Date | 06/11/2006 |
| Last Update Date | 12/28/2011 |
| Medicare PECOS PAC ID | 0840202685 |
|---|---|
| Medicare Enrollment ID | O20060619000270 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598707952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2083 (Connecticut) | Primary |
| Provider Name | Pamela J Deiter-sands |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760526180 PECOS PAC ID: 0749292589 Enrollment ID: I20120103000006 |
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