Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | NY |
NPI | 1013354406 |
---|---|
Provider Name | Candice Dobler |
First Address | Plattsburgh, NY 12901-1627 |
Second Address | Malone, NY 12953-2450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2013 |
Last Update Date | 27/05/2013 |