Provider Demographics
NPI:1053574871
Name:BLINSTRUBAS, DANIELLE AIMEE (PSYD; ABPP)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:AIMEE
Last Name:BLINSTRUBAS
Suffix:
Gender:F
Credentials:PSYD; ABPP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:AIMEE
Other - Last Name:DILDINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:2150 CORBIN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-2298
Mailing Address - Country:US
Mailing Address - Phone:860-827-4751
Mailing Address - Fax:860-832-6278
Practice Address - Street 1:2150 CORBIN AVE
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-2298
Practice Address - Country:US
Practice Address - Phone:860-827-4751
Practice Address - Fax:860-832-6278
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20249103G00000X, 103TC0700X
CAPSY 20249103TR0400X
CT4228103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical