Individual
DR. EDITH PETRELLO HEATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
400 NORTH STREET, NORFOLK, CT 06058-0562
(860) 542-6941
(860) 542-5096
Mailing address
400 NORTH STREET, PO BOX 562, NORFOLK, CT 06058-0562
(860) 542-6941
(860) 542-5096
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
738
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060000738CT02
ANTHEM
CT
01
—
307568
MHN
CT
Enumeration date
10/05/2006
Last updated
07/08/2007
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