Kustron, Debora Ann
Kustron, Debora Ann is an sole proprietor health care provider with primary practice located at 61 Bloomfield Ave 2Nd Floor, Windsor CT 06095-2809. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Kustron, Debora Ann can be contacted via phone (860) 683-2352.Contact Information
Primary practice address
61 Bloomfield Ave 2Nd Floor
Windsor CT 06095-2809
Phone: (860) 683-2352
Fax: (860) 683-2352
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 002140 | Connecticut |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 002140 | Connecticut |
Profile Details
| NPI number | 1316087950 |
|---|---|
| LBN Legal business name | Kustron, Debora Ann |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 6th, 2007 |
| Last updated | Jul 22nd, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316087950 | NPPES |
| Connecticut | Other | 002140 | PSYCHOLOGIST LICENSE |
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