Individual
DR. DONNA K THIELE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
321 DANTE CT STE 30, HOLBROOK, NY 11741-3847
(631) 542-2885
Mailing address
321 DANTE CT STE 30, HOLBROOK, NY 11741-3847
(631) 834-7600
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
000057
NY
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
017221
NY
Other
Enumeration date
07/30/2017
Last updated
10/02/2020
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