Provider Demographics
NPI:1073038840
Name:POSWINSKI, JACQUELINE L (MED)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:L
Last Name:POSWINSKI
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:L
Other - Last Name:GARLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:2 OAK ST FL 2
Mailing Address - Street 2:
Mailing Address - City:YALESVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06492-1707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:162 WEST STREET
Practice Address - Street 2:BLDG 2 SUITE F
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416
Practice Address - Country:US
Practice Address - Phone:860-613-9930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1932440617OtherBEHAVIOR EDUCATION ASSESSMENT AND CONSULTATION SERVICES OF CT