Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC2200X | Clinical Child & Adolescent Psychologist | A42313 | CA |
N | 103TF0000X | Family Psychologist | A42313 | CA |
N | 103TM1800X | Intellectual & Developmental Disabilities | A42313 | CA |
NPI | 1073734984 |
---|---|
Provider Name | Melinda Delcastillo |
First Address | Smithtown, NY 11787 |
Second Address | Smithtown, NY 11787 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 14/04/2008 |