Individual
DR. DIANA BADILLO MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
60 OLD NEW MILFORD RD, SUITE 3D, BROOKFIELD, CT 06804-2430
(203) 775-5183
(203) 775-8453
Mailing address
60 OLD NEW MILFORD RD, SUITE 3D, BROOKFIELD, CT 06804-2430
(203) 775-5183
(203) 775-8453
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1212
CT
103T00000X
Psychologist
1212
CT
103TC0700X
Clinical Psychologist
1212
CT
103TF0200X
Forensic Psychologist
1212
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004069084
—
CT
Enumeration date
02/20/2006
Last updated
07/23/2007
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