Individual
JAYNE COHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
933 HARTFORD TPKE, VERNON, CT 06066-4407
(860) 872-7696
(860) 871-0252
Mailing address
222 TUMBLEBROOK DR, SOUTH WINDSOR, CT 06074-2283
(860) 644-3615
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
001258
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060001258CT02
BLUE SHILD PROVIDER NUMBE
CT
01
—
P557706
OXFORD PROVIER NUMBER
CT
Enumeration date
08/15/2006
Last updated
07/08/2007
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