Individual
CHRISTINE COOLIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
186 W MONTAUK HWY, D1, HAMPTON BAYS, NY 11946
(631) 728-2000
Mailing address
18 DUCKWOOD LANE, HAMPTON BAYS, NY 11946
(631) 728-2000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0148401
NY
364S00000X
Clinical Nurse Specialist
2428621
NY
Other
Enumeration date
08/30/2007
Last updated
08/30/2007
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