Individual
ELIZABETH KIESCHNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
682 PROSPECT AVE, HARTFORD, CT 06105
(860) 231-8900
Mailing address
682 PROSPECT AVE, HARTFORD, CT 06105
(860) 231-8900
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
002125
CT
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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