Provider Demographics
NPI:1659694206
Name:SCHAFF, ELIZABETH HOLLY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:HOLLY
Last Name:SCHAFF
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 1:377 HUBBARD ST
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-3078
Mailing Address - Country:US
Mailing Address - Phone:860-538-4664
Mailing Address - Fax:860-430-5759
Practice Address - Street 1:377 HUBBARD ST
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-3078
Practice Address - Country:US
Practice Address - Phone:860-538-4664
Practice Address - Fax:860-430-5759
Is Sole Proprietor?:No
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002972103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical