Individual
DR. LIESE M ZITZKAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
291 WHITNEY AVE, SUITE 303, NEW HAVEN, CT 06511-3724
(203) 624-0007
Mailing address
291 WHITNEY AVE, SUITE 303, NEW HAVEN, CT 06511-3724
(203) 624-0007
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
3112
CT
103TC0700X
Clinical Psychologist
Primary
9084
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0300010
MBHP
MA
05
—
1300881
—
MA
Enumeration date
07/10/2008
Last updated
08/11/2011
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