Individual
DR. DEBRA GILBERT WAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
264 AMITY RD, STE 213, WOODBRIDGE, CT 06525-2200
(203) 397-0129
Mailing address
264 AMITY RD, STE 213, WOODBRIDGE, CT 06525-2200
(203) 397-0129
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
001240
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11623987
CAQH ID NUMBER
CT
Enumeration date
12/02/2006
Last updated
07/08/2007
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