Provider Demographics
NPI:1225172455
Name:BRETT, ELIZABETH ALLINSON (PHD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ALLINSON
Last Name:BRETT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:BRETT
Other - Last Name:WORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2539
Mailing Address - Country:US
Mailing Address - Phone:203-387-7396
Mailing Address - Fax:203-387-1687
Practice Address - Street 1:400 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2181
Practice Address - Country:US
Practice Address - Phone:203-777-1206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000587103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical