Individual
DR. MICHELLE A. EDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
500 ELM ST, PORTVILLE, NY 14770-9793
(716) 933-6041
Mailing address
PO BOX 172, WEST CLARKSVILLE, NY 14786-0172
(585) 968-1284
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
020218
NY
Other
Enumeration date
09/16/2013
Last updated
09/16/2013
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