Provider Demographics
NPI:1639406630
Name:HINSON, JOSIE VEGA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOSIE
Middle Name:VEGA
Last Name:HINSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WAKEMAN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5120
Mailing Address - Country:US
Mailing Address - Phone:203-450-2181
Mailing Address - Fax:
Practice Address - Street 1:8 WAKEMAN RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5120
Practice Address - Country:US
Practice Address - Phone:203-450-2181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002639103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical