Individual
BLAISE LINDSEY WORDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
200 RETREAT AVENUE, HARTFORD HOSPITAL ANXIETY DISORDERS CENTER, HARTFORD, CT 06106-3310
(860) 545-7685
Mailing address
P.O. BOX 415933, HARTFORD HOSPSITAL PROFESSIONAL SERVICES, BOSTON, MA 02241-5933
(860) 545-7602
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0031958
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008031957
—
CT
Enumeration date
06/20/2012
Last updated
10/04/2012
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