Leland Reback, PsyD
Psychologist in Old Lyme, CT. Individual provider (NPI-1).
NPI number1053957258
StatusActive
Last updated in NPPESNov 22, 2019
Details
- NPI
- 1053957258
- Entity type
- Individual (NPI-1)
- Name
- Leland Reback
- Credential
- PsyD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 22, 2019
- Last updated
- Nov 22, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | 38326 | TX | Yes |
Practice location
55 Hatchetts Hill RdOld Lyme, CT 06371-1534
Phone 800-370-3651
Mailing address
55 Hatchetts Hill RdOld Lyme, CT 06371-1534
Phone 800-370-3651
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