Individual
DEBRA BOLTAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
66 TRUMBULL ST, NEW HAVEN, CT 06510-1012
(203) 787-9119
Mailing address
198 LAWRENCE ST, NEW HAVEN, CT 06511-2417
(203) 824-4476
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
001924
CT
Other
Enumeration date
02/24/2007
Last updated
07/08/2007
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