| Organization Name: | JOHN EDWARD LAMOTHE PHD PSYCHOLOGIST PC |
| NPI Number: | 1811002157 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN EDWARD LAMOTHE (PRESIDENT) |
| Mailing Address: | 124 Dakota Dr Hopewell Jct |
| State: | NY US |
| Postal Code: | 125335866 |
| Phone Number: | 8452276918 |
| Fax Number: | 8452274835 |
| NPI Enumeration Date: | 08/19/2006 |
| NPI Last Update Date: | 01/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 010594-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |