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Individual

ELLEN A DORNELAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
80 SEYMOUR STREET, HARTFORD HOSPITAL ONCOLOGY DEPG, HARTFORD, CT 06102-5037
(860) 545-3790
Mailing address
PO BOX 415933, HARTFORD HOSPITAL PROFESSIONAL SERVICES, BOSTON, MA 02241-5933
(860) 545-7602

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
002046
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008020463
CT
Enumeration date
08/14/2006
Last updated
07/23/2013
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