Organization
HOLLYHOCK PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELOISE MARIE POTENZA PSY.D. (OWNER)
(518) 573-9858
Entity
Organization
Contact information
Practice address
423 KENWOOD AVE, DELMAR, NY 12054-1805
(518) 573-9858
Mailing address
11 PEEL ST, SELKIRK, NY 12158-9734
(518) 573-9858
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
016484
NY
Other
Enumeration date
11/22/2013
Last updated
11/22/2013
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