Doctor Name: | MADLYN MAKBOULIAN |
NPI Number: | 1073936886 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CASAC |
License Number: | 11004 |
Business Practice Address: | 37 John St Amityville, NY - 117012930 |
Business Phone Number: | 6314242900 |
Business Fax Number: | |
Mailing Address: | 41 Woodland Ln, SMITHTOWN |
State: | NY |
Postal Code: | 117874032 |
Phone Number: | 6314242900 |
Fax Number: | |
NPI Enumeration Date: | 01/30/2014 |
NPI Last Update Date: | 01/30/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 11004 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |