Doctor Name: | DANA THOMSON |
NPI Number: | 1154747152 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY, D. |
License Number: | 020379 |
Business Practice Address: | 350 Martha Ave Bellport, NY - 117131525 |
Business Phone Number: | 5166557957 |
Business Fax Number: | |
Mailing Address: | 40 Leonard Dr, MASSAPEQUA |
State: | NY |
Postal Code: | 117587920 |
Phone Number: | 5166557957 |
Fax Number: | |
NPI Enumeration Date: | 03/14/2014 |
NPI Last Update Date: | 03/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 020379 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |