Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1083813976 |
---|---|
Provider Name | Melissa Whitson |
First Address | Port Ewen, NY 12466-5603 |
Second Address | Kingston, NY 12401-6441 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2007 |
Last Update Date | 12/07/2007 |