Organization
CHILD PSYCHOLOGY OF LONG ISLAND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACALYN BRUNO PSY.D. (PSYCHOLOGIST)
(631) 806-6889
Entity
Organization
Contact information
Practice address
55 WEEKS ST, BLUE POINT, NY 11715-1516
(631) 806-6889
Mailing address
55 WEEKS ST, BLUE POINT, NY 11715-1516
(631) 806-6889
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
103TS0200X
School Psychologist
—
—
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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