Individual
DR. JOANNE M LERTORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
133 MOUNTAIN RD, SUFFIELD, CT 06078-2084
(860) 644-0651
Mailing address
PO BOX 374, SUFFIELD, CT 06078-0374
(860) 644-0651
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
CT 1626
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4125317
—
CT
Enumeration date
10/18/2006
Last updated
05/28/2020
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