Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 017556 | NY |
Y | 103TC0700X | Clinical Psychologist | 017556 | NY |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 017556 | NY |
N | 103TR0400X | Rehabilitation Psychologist | 017556 | NY |
NPI | 1164693438 |
---|---|
Provider Name | Dr. Deborah Eileen Spinks |
First Address | Syracuse, NY 13204-1492 |
Second Address | Syracuse, NY 13210-2342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2008 |
Last Update Date | 14/03/2008 |