# JUDI DOBNER THERAPIST AGENCY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** JDTA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033345186
- **Authorized official:** DR. SAM DOBNER PHD (CEO)
- **Authorized official phone:** (845) 368-7927

## Contact information

- **Practice address:** 386 ROUTE 59, SUITE 102, AIRMONT, NY 10952-3428
- **Practice address phone:** (845) 368-7927
- **Practice address fax:** (845) 368-7929
- **Mailing address:** 386 ROUTE 59, SUITE 102, AIRMONT, NY 10952-3428
- **Mailing address phone:** (845) 368-7927
- **Mailing address fax:** (845) 368-7929

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 06/03/2009
- **Last updated:** 06/03/2009