Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 016143 | NY |
Y | 103G00000X | Clinical Psychologist | 016143 | NY |
Y | 103TC0700X | Clinical Psychologist | 016143 | NY |
N | 103TP2701X | Group Psychotherapist | 016143 | NY |
NPI | 1174892277 |
---|---|
Provider Name | Dr. Jennifer Anne May |
First Address | Oakdale, NY 11769-1445 |
Second Address | East Setauket, NY 11733-6400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2011 |
Last Update Date | 19/12/2011 |