Doctor Name: | DR. RACHAEL SMITH-SPONHOLZ |
NPI Number: | 1194101428 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | 021266 |
Business Practice Address: | 150 Stahl Rd Getzville, NY - 140681231 |
Business Phone Number: | 7166293447 |
Business Fax Number: | 7166293494 |
Mailing Address: | 150 Stahl Rd, GETZVILLE |
State: | NY |
Postal Code: | 140681231 |
Phone Number: | 7166293447 |
Fax Number: | 7166293494 |
NPI Enumeration Date: | 08/10/2015 |
NPI Last Update Date: | 08/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | 021266 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |