Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 020430 | NY |
Y | 103G00000X | Clinical Psychologist | 020430 | NY |
Y | 103TC0700X | Clinical Psychologist | 020430 | NY |
N | 103TH0004X | Health Psychologist | 020430 | NY |
N | 103TR0400X | Rehabilitation Psychologist | 020430 | NY |
NPI | 1417372103 |
---|---|
Provider Name | Dr. Dana Catharine Nevedal |
First Address | Albany, NY 12205-3833 |
Second Address | Albany, NY 12205-3833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2014 |
Last Update Date | 13/07/2015 |