Most Relevant Information
Provider Data
| NPI Number: | 1003263245 |
| Provider Name: | KENT SUNDERLAND PSYD |
| Entity Type: | Individual |
| Taxonomy Code: | 103TC0700X |
| Specialty: | Psychologist |
| License Number: | 3559 |
Most Important Dates
| Enumeration Date: | 05/18/2016 |
| Last Updated: | 05/18/2016 |
Provider Practice Location
675 MAIN STREET
MIDDLETOWN
CT
064572632
Practice Location Phone/Fax
| Phone: | 8603476971 |
| Fax: | 8607048034 |
Provider Mailing Location
675 MAIN STREET
MIDDLETOWN
CT
064572632
Provider Mailing Phone/Fax
| Phone: | 8603476971 |
| Fax: | 8607048034 |