Organization
ON-SITE PSYCHOLOGICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE L PRENETA (CLINICAL DIRECTOR)
(203) 438-7565
Entity
Organization
Contact information
Practice address
415 MAIN ST, RIDGEFIELD, CT 06877-4500
(203) 438-7565
Mailing address
PO BOX 1107, RIDGEFIELD, CT 06877
(203) 438-7565
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03333406
—
NY
Enumeration date
09/02/2006
Last updated
05/21/2019
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