Individual
DR. TAIKI MATSUURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
200 EDISON RD, ORANGE, CT 06477-3602
(203) 551-0132
Mailing address
200 EDISON RD, ORANGE, CT 06477-3602
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
023957
NY
Other
Enumeration date
11/12/2020
Last updated
12/02/2020
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