Doctor Name: | CHRISTINE COPPOLA MINK |
NPI Number: | 1073789210 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 011552-1 |
Business Practice Address: | 37 Moore Ave Mount Kisco, NY - 105493127 |
Business Phone Number: | 9142441467 |
Business Fax Number: | 9142410521 |
Mailing Address: | 37 Moore Ave, MOUNT KISCO |
State: | NY |
Postal Code: | 105493127 |
Phone Number: | 9142441467 |
Fax Number: | 9142410521 |
NPI Enumeration Date: | 05/07/2008 |
NPI Last Update Date: | 05/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 011552-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |