Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 019611 | NY |
Y | 103T00000X | Psychologist | 019611 | NY |
N | 103TS0200X | School Psychologist | 019611 | NY |
NPI | 1013202944 |
---|---|
Provider Name | Dr. Laura Anne Van Schaick-Harman |
First Address | Patchogue, NY 11772-1555 |
Second Address | Patchogue, NY 11772-1555 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2011 |
Last Update Date | 30/11/2015 |