Provider Demographics
NPI:1093891434
Name:MORISANO, ELAINE R (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:R
Last Name:MORISANO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 MOHAWK DR
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06019-3527
Mailing Address - Country:US
Mailing Address - Phone:860-693-8976
Mailing Address - Fax:
Practice Address - Street 1:37 MOHAWK DR
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:CT
Practice Address - Zip Code:06019-3527
Practice Address - Country:US
Practice Address - Phone:860-693-8976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1009103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist