Provider Demographics
NPI:1447301767
Name:CASTIGLIONE, TANYA SHRIVER (PHD)
Entity type:Individual
Prefix:DR
First Name:TANYA
Middle Name:SHRIVER
Last Name:CASTIGLIONE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 JUDITH DR
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-3447
Mailing Address - Country:US
Mailing Address - Phone:203-748-2778
Mailing Address - Fax:
Practice Address - Street 1:36 JUDITH DR
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-3447
Practice Address - Country:US
Practice Address - Phone:203-748-2778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001759103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical