Individual
DR. JACLYN SPIEGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1428 5TH AVE, BAY SHORE, NY 11706-4147
(631) 665-1900
Mailing address
1912 TANWOOD CT, NORTH BELLMORE, NY 11710-3154
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
019721
NY
103TS0200X
School Psychologist
1875262
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03926969
—
NY
Enumeration date
07/05/2011
Last updated
09/18/2015
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