Individual
DR. DONNA KATHY NISSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
55 SANDY HOLLOW RD, NORTHPORT, NY 11768
(631) 261-3958
Mailing address
55 SANDY HOLLOW RD, NORTHPORT, NY 11768
(631) 261-3958
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0117691
NY
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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