Doctor Name: | MRS. CATHERINE DIANE DEFAYETTE |
NPI Number: | 1881905040 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., C.A.S. |
License Number: | 608893951 |
Business Practice Address: | 47 Sand Rd Morrisonville, NY - 129622924 |
Business Phone Number: | 5185655980 |
Business Fax Number: | 5185655972 |
Mailing Address: | 47 Sand Rd, MORRISONVILLE |
State: | NY |
Postal Code: | 129622924 |
Phone Number: | 5185655980 |
Fax Number: | 5185655972 |
NPI Enumeration Date: | 06/23/2010 |
NPI Last Update Date: | 06/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 608893951 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |