Individual
DEBRA D CASSIDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1745 BROADWAY, 17 FL, NEW YORK, NY 10019-4640
(212) 851-8100
(212) 537-0102
Mailing address
47 LINCOLN PL, MASSAPEQUA, NY 11758-7037
(516) 319-6928
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
019205-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03564692
—
NY
Enumeration date
09/01/2011
Last updated
06/10/2015
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