Individual
SHAWNNIECE TENAY PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
45 A ST, BUFFALO, NY 14211-3203
(716) 370-0292
Mailing address
45 A STREET, BUFFALO, NY 14211
(716) 370-0292
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
294304071
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
294304071
—
NY
Enumeration date
07/17/2017
Last updated
07/21/2022
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