Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 020756-1 | NY |
N | 103T00000X | Psychologist | 020756-1 | NY |
Y | 103G00000X | Clinical Psychologist | 020756-1 | NY |
Y | 103TC0700X | Clinical Psychologist | 020756-1 | NY |
N | 103TC1900X | Counseling Psychologist | 020756-1 | NY |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 020756-1 | NY |
NPI | 1124262456 |
---|---|
Provider Name | Dr. Vanessa P. Caskey |
First Address | Woodside, NY 11377-6586 |
Second Address | New York, NY 10011-8409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2009 |
Last Update Date | 14/10/2014 |