Provider Demographics
NPI:1184825804
Name:HOPKINS, PHYLLIS F (PHD)
Entity Type:Individual
Prefix:MS
First Name:PHYLLIS
Middle Name:F
Last Name:HOPKINS
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 1:345 QUENBY PL
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-1865
Mailing Address - Country:US
Mailing Address - Phone:203-386-8147
Mailing Address - Fax:203-386-1029
Practice Address - Street 1:345 QUENBY PL
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-1865
Practice Address - Country:US
Practice Address - Phone:203-386-8147
Practice Address - Fax:203-386-1029
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001437103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist