Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 012465 | NY |
Y | 103TC0700X | Clinical Psychologist | 012465 | NY |
N | 103TC1900X | Counseling Psychologist | 012465-1 | NY |
NPI | 1013948272 |
---|---|
Provider Name | Dr. Joelle Efthimiou |
First Address | Hampton Bays, NY 11946-3620 |
Second Address | Hampton Bays, NY 11946-3620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 11/08/2020 |