Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 024696 | NY |
NPI | 1114670957 |
---|---|
Provider Name | Dr. Katherine Jeannette Neely |
First Address | Williamsville, NY 14221-2107 |
Second Address | Williamsville, NY 14221-2107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2022 |
Last Update Date | 01/02/2022 |