Individual
AIEYAT BASIM ZALZALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
200 RETREAT AVE, HARTFORD HOSPITAL PSYCHIATRY DEPT, HARTFORD, CT 06106-3309
(860) 696-0020
Mailing address
200 RETREAT AVENUE, HARTFORD HOSPITAL PSYCHIATRY DEPT, HARTFORD, CT 06106-3309
(860) 696-0020
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
003856
CT
103TC1900X
Counseling Psychologist
3856
CT
Other
Enumeration date
09/10/2019
Last updated
11/22/2019
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