Individual
DR. CLARISSE G DICANDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
567 VAUXHALL ST EXT, SUITE 304, WATERFORD, CT 06385
(860) 442-6777
(203) 481-5291
Mailing address
PO BOX 333, MYSTIC, CT 06355-0333
(860) 442-6777
(203) 481-5291
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
001698
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060001698CT02
ANTHEM BCBS
CT
01
—
168925
MHN
CT
01
—
5217064
AETNA
CT
Enumeration date
03/13/2007
Last updated
07/08/2007
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