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Individual

DR. MARY GOLDSTEIN MARCUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
10 WALL ST, NORWALK, CT 06850-3438
(203) 847-3369
(203) 454-0404
Mailing address
63 GODFREY RD W, WESTON, CT 06883-1304
(203) 221-0547
(203) 454-0404

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
000804
CT
103T00000X
Psychologist
3560
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000804
PSYCHOLOGIST LICENSE
CT
01
3560
PSYCHOLOGIST LICENSE
AZ
Enumeration date
08/04/2006
Last updated
07/08/2007
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