| Doctor Name: | MS. JUDY CANNATA |
| NPI Number: | 1336400605 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW-R |
| License Number: | R070078-1 |
| Business Practice Address: | 88 Lake Hill Rd Burnt Hills, NY - 120279598 |
| Business Phone Number: | 5183999141 |
| Business Fax Number: | 5183994341 |
| Mailing Address: | 88 Lake Hill Rd, BURNT HILLS |
| State: | NY |
| Postal Code: | 120279598 |
| Phone Number: | 5183999141 |
| Fax Number: | 5183994341 |
| NPI Enumeration Date: | 06/04/2012 |
| NPI Last Update Date: | 06/04/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041S0200X |
| License Number: | R070078-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |