Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 008979 | NY |
NPI | 1114429461 |
---|---|
Provider Name | Dr. Joan Mccool |
First Address | East Amherst, NY 14051-2047 |
Second Address | Williamsville, NY 14221-6705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2018 |
Last Update Date | 02/03/2018 |