Doctor Name: | MS. PAULINE BERNARD |
NPI Number: | 1790118701 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 005678 |
Business Practice Address: | 9502 Rockaway Beach Blvd Rockaway Beach, NY - 116931317 |
Business Phone Number: | 7184742035 |
Business Fax Number: | 7174742165 |
Mailing Address: | 9502 Rockaway Beach Blvd, ROCKAWAY BEACH |
State: | NY |
Postal Code: | 116931317 |
Phone Number: | 7184742035 |
Fax Number: | 7174742165 |
NPI Enumeration Date: | 08/13/2013 |
NPI Last Update Date: | 08/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 005678 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |