Provider Demographics
NPI:1184168981
Name:PATTI, ANNE M (PHD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:M
Last Name:PATTI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W CENTER ST
Mailing Address - Street 2:SUITE C-3
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-4864
Mailing Address - Country:US
Mailing Address - Phone:844-428-8728
Mailing Address - Fax:
Practice Address - Street 1:200 W CENTER ST
Practice Address - Street 2:SUITE C-3
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-4864
Practice Address - Country:US
Practice Address - Phone:844-428-8728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002091103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical