Provider Demographics
NPI:1205517745
Name:DITORO, MOLLY KATE
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:KATE
Last Name:DITORO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 N JOHNSON LN
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-2245
Mailing Address - Country:US
Mailing Address - Phone:203-627-2388
Mailing Address - Fax:
Practice Address - Street 1:615 N JOHNSON LN
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-2245
Practice Address - Country:US
Practice Address - Phone:203-627-2388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1713103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst