| Doctor Name: | MS. KATHLEEN A DE JONG |
| NPI Number: | 1336119031 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CSW-R |
| License Number: | 053935 |
| Business Practice Address: | 193 Renwick Rd Burlington Flats, NY - 133153133 |
| Business Phone Number: | 6079658075 |
| Business Fax Number: | |
| Mailing Address: | 193 Renwick Rd, BURLINGTON FLATS |
| State: | NY |
| Postal Code: | 133153133 |
| Phone Number: | 6079658075 |
| Fax Number: | |
| NPI Enumeration Date: | 01/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 053935 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |