Individual
DR. ELIZABETH A MONGILLO-HERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
784 FARMINGTON AVE, WEST HARTFORD, CT 06119-1619
(860) 523-4450
(860) 523-9537
Mailing address
784 FARMINGTON AVE, WEST HARTFORD, CT 06119-1619
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
003111
CT
103TC0700X
Clinical Psychologist
9381
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008045664
—
CT
Enumeration date
08/06/2009
Last updated
02/21/2014
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