Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 011082 | NY |
Y | 103TC0700X | Clinical Psychologist | 011082 | NY |
NPI | 1003909029 |
---|---|
Provider Name | Dr. Doreen Harris |
First Address | Scotia, NY 12302-3705 |
Second Address | Albany, NY 12208-3410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/07/2007 |