Provider Demographics
NPI:1487877015
Name:SOLLINGER, IRWIN D (PHD)
Entity type:Individual
Prefix:DR
First Name:IRWIN
Middle Name:D
Last Name:SOLLINGER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BAYBERRY LN
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4002
Mailing Address - Country:US
Mailing Address - Phone:203-226-5987
Mailing Address - Fax:203-454-9668
Practice Address - Street 1:102 BAYBERRY LN
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4002
Practice Address - Country:US
Practice Address - Phone:203-226-5987
Practice Address - Fax:203-454-9668
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT466103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist