Organization
STABLE GROUNDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA A COHEN PSYD (PSYCHOLOGIST/ OWNER)
(203) 747-8734
Entity
Organization
Contact information
Practice address
21 HAZEL TER, SUITE B, WOODBRIDGE, CT 06525-2209
(203) 747-8734
Mailing address
21 HAZEL TER, SUITE B, WOODBRIDGE, CT 06525-2209
(203) 747-8734
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
003385
CT
103TB0200X
Cognitive & Behavioral Psychologist
003383
CT
103TC0700X
Clinical Psychologist
003385
CT
103TC2200X
Clinical Child & Adolescent Psychologist
003385
CT
Other
Enumeration date
12/18/2014
Last updated
12/18/2014
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