Doctor Name: | DR. CHRYSTAL JOY AGNOR |
NPI Number: | 1215241781 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 1612 |
Business Practice Address: | 745a Brewerton Road Center For Personal Development/uscc West Point, NY - 10996 |
Business Phone Number: | 8459387979 |
Business Fax Number: | 8459384056 |
Mailing Address: | 745a Brewerton Road, Center For Personal Development/uscc WEST POINT |
State: | NY |
Postal Code: | 10996 |
Phone Number: | 8459387979 |
Fax Number: | 8459384056 |
NPI Enumeration Date: | 07/27/2010 |
NPI Last Update Date: | 07/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 1612 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |