Provider Demographics
NPI:1578616629
Name:HINCHMAN, MARY MITCHELL (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:MITCHELL
Last Name:HINCHMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:HINCHMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:104 DIBBLE HILL RD
Mailing Address - Street 2:
Mailing Address - City:WEST CORNWALL
Mailing Address - State:CT
Mailing Address - Zip Code:06796-1515
Mailing Address - Country:US
Mailing Address - Phone:860-672-6386
Mailing Address - Fax:
Practice Address - Street 1:104 DIBBLE HILL RD
Practice Address - Street 2:
Practice Address - City:WEST CORNWALL
Practice Address - State:CT
Practice Address - Zip Code:06796-1515
Practice Address - Country:US
Practice Address - Phone:860-672-6386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT890103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist