Lertora, Joanne M

Lertora, Joanne M is an sole proprietor health care provider with primary practice located at 133 Mountain Rd , Suffield CT 06078-2084. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Lertora, Joanne M can be contacted via phone (860) 644-0651.

Contact Information

Primary practice address
133 Mountain Rd Suffield CT 06078-2084
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X CT 1626 Connecticut

Profile Details

NPI number 1154402899
LBN Legal business name Lertora, Joanne M
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 18th, 2006
Last updated May 28th, 2020 - about 5 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 1154402899 NPPES
Connecticut MEDICAID 4125317

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