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Organization

JACQUELINE SHALL-MCCUMISKEY, PSY.D. MINDFUL PRACTICE

Active
Parent organization
1104699974
Other names
JACQUELINE SHALL-MCCUMISKEY, PSY.D., PLLC, JACQUELINE SHALL-MCCUMISKEY, PSY.D. Mindful Practice
Organization subpart
Yes

Provider details

NPI number
Legal business name
1104699974
Authorized official
JACQUELINE SHALL-MCCUMISKEY (OWNER)
(646) 479-8068
Entity
Organization

Contact information

Practice address
1675 RICHMOND RD, STATEN ISLAND, NY 10304-2317
(646) 479-8068
Mailing address
1675 RICHMOND RD, STATEN ISLAND, NY 10304-2317

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary

Other

Enumeration date
11/03/2023
Last updated
03/03/2025
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