Doctor Name: | ELAINE DYKEMAN |
NPI Number: | 1124426473 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 72057377 |
Business Practice Address: | 770 Embought Rd Catskill, NY - 124145312 |
Business Phone Number: | 5189430574 |
Business Fax Number: | 5189435396 |
Mailing Address: | 772 Sleepy Hollow Rd, #1155 ATHENS |
State: | NY |
Postal Code: | 120153128 |
Phone Number: | 5189430574 |
Fax Number: | 5189435396 |
NPI Enumeration Date: | 12/18/2014 |
NPI Last Update Date: | 12/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | 72057377 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |