Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 020478 | NY |
N | 103TC0700X | Clinical Psychologist | 020478 | NY |
Y | 103G00000X | Clinical Psychologist | 020478 | NY |
Y | 103TC0700X | Clinical Psychologist | 020478 | NY |
N | 103TR0400X | Rehabilitation Psychologist | 020478 | NY |
NPI | 1487031399 |
---|---|
Provider Name | Dr. Nicole Murray |
First Address | Lewiston, NY 14092-1705 |
Second Address | Lewiston, NY 14092-1705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2015 |
Last Update Date | 23/04/2020 |