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Organization

DR. KATHERINE BOTHOS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KATHERINE BOTHOS PSY.D (LICENSED CLINICAL PSYCHOLOGIST)
(203) 445-3736
Entity
Organization

Contact information

Practice address
170 POST RD, SUITE 208, FAIRFIELD, CT 06824-6262
(203) 445-3736
Mailing address
170 POST RD, SUITE 208, FAIRFIELD, CT 06824-6262
(203) 445-3736

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
002950
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008025366
CT
Enumeration date
10/19/2016
Last updated
10/19/2016
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