Glastonbury Pediatric Neuropsychology

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

GLASTONBURY PEDIATRIC NEUROPSYCHOLOGY

Practice address

78 Eastern Blvd
Glastonbury, CT 06033-4325

Phone

(860) 430-2736

NPI assigned

Apr 24, 2025

Last updated

Apr 24, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Krista Mraz, PH.D.

Title

Clinical Psychologist

Phone

(860) 430-2736

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1745452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1043007792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 EASTERN BLVD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334325",
            "telephone_number": "860-430-2736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 EASTERN BLVD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334325",
            "telephone_number": "860-430-2736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLASTONBURY PEDIATRIC NEUROPSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A",
        "authorized_official_last_name": "MRAZ",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "860-430-2736",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glastonbury Family Medicine LLC
• Glastonbury Health Care Center Inc
• Glastonbury Health Care Center, Inc.
• Glastonbury Naturopathic Center LLC
• Glastonbury Osteopathic, LLC
• Glastonbury Pediatrics
• Glastonbury Physical Therapy, LLC
• Glastonbury Podiatry Group
• Glastonbury Psychiatric Care LLC
• Glastonbury Psychological Associates, PC

• Clinical Psychologist in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.