Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 014378 | NY |
Y | 103TC0700X | Clinical Psychologist | 014378 | NY |
NPI | 1013098847 |
---|---|
Provider Name | Dr. Judy L O'leary-Sargeant |
First Address | Penfield, NY 14526-2687 |
Second Address | Penfield, NY 14526-2687 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 08/07/2007 |