Provider Demographics
NPI:1619136223
Name:MOONAN, PATRICIA MURPHY
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MURPHY
Last Name:MOONAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:ELIZABETH
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:234 FITCH PASS
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-5602
Mailing Address - Country:US
Mailing Address - Phone:203-445-9154
Mailing Address - Fax:
Practice Address - Street 1:238 JEWETT AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-2845
Practice Address - Country:US
Practice Address - Phone:203-372-4301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist