Individual
MRS. REBECCA J MINCKLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA/CAS
Contact information
Practice address
16783 IVES STREET ROAD, WATERTOWN, NY 13601
(315) 788-5377
Mailing address
16783 IVES STREET ROAD, WATERTOWN, NY 13601
(315) 788-5377
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
837065
NY
Other
Enumeration date
01/03/2013
Last updated
09/17/2022
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