Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 011033 | NY |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 011033 | NY |
Y | 103G00000X | Clinical Psychologist | 011033 | NY |
Y | 103TC0700X | Clinical Psychologist | 011033 | NY |
N | 103TF0000X | Family Psychologist | 011033 | NY |
NPI | 1316928245 |
---|---|
Provider Name | Dr. Tedd R. Habberfield |
First Address | Williamsville, NY 14221-6705 |
Second Address | Williamsville, NY 14221-6705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 23/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000511263001 | HEALTH NOW (01) | NY |
20207801 | EXCELLUS HEALTH (01) | NY |
6104050 | INDEPENDENT HEALTH (01) | NY |