Provider Demographics
NPI:1629206057
Name:CHIPMAN, DOROTA M (MFT)
Entity Type:Individual
Prefix:MS
First Name:DOROTA
Middle Name:M
Last Name:CHIPMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 STATE STREET
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511
Mailing Address - Country:US
Mailing Address - Phone:203-752-1212
Mailing Address - Fax:203-752-1769
Practice Address - Street 1:1435 STATE ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-2702
Practice Address - Country:US
Practice Address - Phone:203-752-1212
Practice Address - Fax:203-752-1769
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist