Individual
ELISE KABELA-CORMIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
263 FARMINGTON AVE, PSYCHIATRY ASSOCIATES, FARMINGTON, CT 06030-0001
(860) 679-6700
(860) 679-6736
Mailing address
65 KANE ST, PROVIDER ENROLLMENT, WEST HARTFORD, CT 06119-2110
(860) 523-6421
(860) 523-3701
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
001500
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225036171
—
CT
Enumeration date
07/13/2005
Last updated
09/12/2022
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