Individual
RENE SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
727 N BROADWAY, MASSAPEQUA, NY 11758-2348
(800) 871-5491
Mailing address
75 CHELSEA AVE, WEST BABYLON, NY 11704-3906
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
02/24/2025
Last updated
02/24/2025
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