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Individual
DR. NINA OBOLENSKY PRUDDEN
Active
Individual
DR. NINA OBOLENSKY PRUDDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
200571
NY
103T00000X
Psychologist
200571
NY
103TA0400X
Addiction (Substance Use Disorder) Psychologist
200571
NY
103TC0700X
Clinical Psychologist
Primary
200571
NY
103TC2200X
Clinical Child & Adolescent Psychologist
200571
NY
103TM1800X
Intellectual & Developmental Disabilities Psychologist
200571
NY
103TS0200X
School Psychologist
200571
NY
Other
Enumeration date
06/24/2013
Last updated
02/12/2015
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