Individual
DR. LESLIE BLOCH WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
315 WHITNEY AVE, SUITE 2, NEW HAVEN, CT 06511-3715
(203) 865-6156
(203) 777-2257
Mailing address
315 WHITNEY AVE, SUITE 2, NEW HAVEN, CT 06511-3715
(203) 865-6156
(203) 777-2257
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
629
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060000629CT01
ANTHEM
CT
01
—
6896475
VALUE OPTIONS
CT
01
—
MHN
173197
CT
Enumeration date
07/08/2006
Last updated
07/08/2007
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