Doctor Name: | STACY JAIKARAN |
NPI Number: | 1285039370 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | 885311141 |
Business Practice Address: | 117 S Highland Ave Apt 4b Ossining, NY - 105625837 |
Business Phone Number: | 6462622235 |
Business Fax Number: | |
Mailing Address: | 117 S Highland Ave Apt 4b, OSSINING |
State: | NY |
Postal Code: | 105625837 |
Phone Number: | 6462622235 |
Fax Number: | |
NPI Enumeration Date: | 10/31/2014 |
NPI Last Update Date: | 10/31/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 885311141 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |