Doctor Name: | MR. JEDIDIAH GUNTER |
NPI Number: | 1689091290 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D |
License Number: | 020455 |
Business Practice Address: | 34 S Broadway Suite 500 White Plains, NY - 106014400 |
Business Phone Number: | 9149494045 |
Business Fax Number: | 9149498065 |
Mailing Address: | 34 S Broadway, Suite 500 WHITE PLAINS |
State: | NY |
Postal Code: | 106014400 |
Phone Number: | 9149494045 |
Fax Number: | 9149498065 |
NPI Enumeration Date: | 03/20/2014 |
NPI Last Update Date: | 03/20/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 020455 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |