Individual
DR. JOAN ANNE MACKELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
7 HOLLYWOOD AVENUE, DOUGLAS MANOR, NY 11363
(917) 543-5751
Mailing address
7 HOLLYWOOD AVENUE, DOUGLAS MANOR, NY 11363-1107
(917) 543-5751
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
012395-1
NY
103TB0200X
Cognitive & Behavioral Psychologist
012395-1
NY
103TC0700X
Clinical Psychologist
Primary
012395-1
NY
Other
Enumeration date
01/28/2019
Last updated
06/11/2019
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