Provider Demographics
NPI:1952086407
Name:OPROMOLLO, CHRISTYN MARIE (PSYD)
Entity type:Individual
Prefix:
First Name:CHRISTYN
Middle Name:MARIE
Last Name:OPROMOLLO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:CHRISTYN
Other - Middle Name:MARIE
Other - Last Name:DRANGINIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:477 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:HAWLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18428-4570
Mailing Address - Country:US
Mailing Address - Phone:973-610-9677
Mailing Address - Fax:
Practice Address - Street 1:2300 MAIN ST
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2218
Practice Address - Country:US
Practice Address - Phone:860-430-1762
Practice Address - Fax:860-430-1767
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4872103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist