Provider Demographics
NPI:1528174935
Name:WERNER, ARLENE B (PHD PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:B
Last Name:WERNER
Suffix:
Gender:F
Credentials:PHD PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 HAMILTON AVE UNIT 207
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-4890
Mailing Address - Country:US
Mailing Address - Phone:860-599-4643
Mailing Address - Fax:
Practice Address - Street 1:567 VAUXHALL STREET EXT STE 207
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-4332
Practice Address - Country:US
Practice Address - Phone:860-599-4643
Practice Address - Fax:860-599-4643
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001644103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004150629Medicaid
CT004150629Medicaid