Organization Name: | KARIN CONNELLY PHD PSYCHOLOGY COACHING PLLC |
NPI Number: | 1265854996 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KARIN A CONNELLY (PSYCHOLOGIST) |
Mailing Address: | 1 Commons Dr Lake Katrine |
State: | NY US |
Postal Code: | 124495149 |
Phone Number: | 8457500476 |
Fax Number: | 8453364014 |
NPI Enumeration Date: | 01/15/2014 |
NPI Last Update Date: | 01/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 012496 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |