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Individual

DR. JENNIFER LITTERICK SONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
760 PERINTON HILLS OFFICE PARK, FAIRPORT, NY 14450
(585) 223-5920
(585) 223-5727
Mailing address
1016 ROYAL DR, VICTOR, NY 14564
(585) 742-2092

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
013742
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
125747FC
PREFERRED CARE
NY
01
7391612
AETNA
NY
Enumeration date
09/07/2006
Last updated
07/08/2007
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