Individual
MARY JO PUGLISI VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2335 BLACK ROCK TPKE, HALL #2, FAIRFIELD, CT 06825-3220
(203) 816-0183
Mailing address
2335 BLACK ROCK TPKE, HALL #2, FAIRFIELD, CT 06825-3220
(203) 816-0183
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3188
CT
2084P0805X
Geriatric Psychiatry Physician
016768
NY
Other
Enumeration date
03/31/2007
Last updated
05/16/2014
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