Provider Demographics
NPI:1790089126
Name:SUTERA HOGAN, SAASHA (PHD)
Entity Type:Individual
Prefix:DR
First Name:SAASHA
Middle Name:
Last Name:SUTERA HOGAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SAASHA
Other - Middle Name:
Other - Last Name:SUTERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:383 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4652
Mailing Address - Country:US
Mailing Address - Phone:203-939-3001
Mailing Address - Fax:
Practice Address - Street 1:383 MAIN ST
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4652
Practice Address - Country:US
Practice Address - Phone:203-939-3001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003066103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical