Provider Demographics
NPI:1821394925
Name:MARIA GUGLIELMINO, PSY.D., LLC
Entity Type:Organization
Organization Name:MARIA GUGLIELMINO, PSY.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUGLIELMINO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:203-266-9253
Mailing Address - Street 1:P. O. BOX 39
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06798
Mailing Address - Country:US
Mailing Address - Phone:203-266-9253
Mailing Address - Fax:
Practice Address - Street 1:40 MAIN ST N
Practice Address - Street 2:SUITE 2-F
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798-2966
Practice Address - Country:US
Practice Address - Phone:203-266-9253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002622103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty