Individual
DR. AMBER SOUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1050 HALLOCK AVE STE 1, PORT JEFFERSON STATION, NY 11776-1214
(631) 676-1962
(631) 676-1959
Mailing address
216 S 5TH ST, LINDENHURST, NY 11757-4621
(631) 680-5646
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
0211671
NY
Other
Enumeration date
02/18/2016
Last updated
02/18/2016
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