Individual
KRISTINA MARIE HALLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., ABPP
Contact information
Practice address
880 BURBANK AVE, SUFFIELD, CT 06078-1459
(860) 965-1655
Mailing address
880 BURBANK AVE, SUFFIELD, CT 06078-1459
(860) 965-1655
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
002493
CT
103TC0700X
Clinical Psychologist
6905
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002493
LICENSE
CT
01
—
W05752
BLUE CROSS
MA
05
—
W50652
—
MA
Enumeration date
06/09/2006
Last updated
07/12/2022
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