Organization
PSYCHOLOGICAL SERVICES FOR SELF AND FAMILY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL M. COHEN PH.D. (OWNER)
(315) 637-9131
Entity
Organization
Contact information
Practice address
523 E GENESEE ST, FAYETTEVILLE, NY 13066-1536
(315) 637-9131
(315) 637-9151
Mailing address
523 E GENESEE ST, FAYETTEVILLE, NY 13066-1536
(315) 637-9131
(315) 637-9151
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
009823-1
NY
Other
Enumeration date
07/19/2010
Last updated
07/19/2010
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