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Individual

DR. JESSICA MARIE HUSSAR BOYLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
269 RIVERSIDE DR, JOHNSON CITY, NY 13790-2726
(607) 252-6634
(607) 203-5720
Mailing address
23 HICKORY RD, BINGHAMTON, NY 13905-1347

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
023416
NY
103TS0200X
School Psychologist
993174151
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
023416
PSYCHOLOGIST LICENSE NUMBER
NY
01
41401
NCSP CERTIFICATION NUMBER
01
993174151
SCHOOL PSYCHOLOGIST STATE CERTIFICATION CONTROL NUMBER
NY
Enumeration date
09/13/2012
Last updated
06/28/2023
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