Hallett, Kristina Marie

Hallett, Kristina Marie is an sole proprietor health care provider with primary practice located at 880 Burbank Ave , Suffield CT 06078-1459. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Hallett, Kristina Marie can be contacted via phone (860) 965-1655.

Contact Information

Primary practice address
880 Burbank Ave Suffield CT 06078-1459
Phone: (860) 965-1655
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 6905 Massachusetts
Behavioral Health & Social Service Providers / Clinical 103TC0700X 002493 Connecticut

Profile Details

NPI number 1841231917
LBN Legal business name Hallett, Kristina Marie
Credentials PH.D., ABPP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 9th, 2006
Last updated Jul 12th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841231917 NPPES
Massachusetts Other W05752 BLUE CROSS
Massachusetts Other 002493 BLUE CROSS
Massachusetts MEDICAID W50652 BLUE CROSS

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