Doctor Name: | JESSICA REDIS |
NPI Number: | 1770778003 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 50 Dayton Ln Ste 205 Andrus Children's Center Peekskill, NY - 105662860 |
Business Phone Number: | 9147363371 |
Business Fax Number: | 9147363372 |
Mailing Address: | 1156 N Broadway, Andrus Children's Center YONKERS |
State: | NY |
Postal Code: | 107011108 |
Phone Number: | 9149653700 |
Fax Number: | 9149653883 |
NPI Enumeration Date: | 09/10/2007 |
NPI Last Update Date: | 11/30/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |