Doctor Name: | MR. DARRELL DWYER |
NPI Number: | 1689077216 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 003614-1 |
Business Practice Address: | 22 Rocky Ln Garrison, NY - 105243811 |
Business Phone Number: | 9143914503 |
Business Fax Number: | 8454243586 |
Mailing Address: | 22 Rocky Ln, GARRISON |
State: | NY |
Postal Code: | 105243811 |
Phone Number: | 9143914503 |
Fax Number: | 8454243586 |
NPI Enumeration Date: | 09/26/2014 |
NPI Last Update Date: | 09/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 003614-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |