Organization
WELL CHILD PSYCHIATRIC NP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBRA PEDERSEN (CREDENTIALING SPECIALIST)
(518) 631-8268
Entity
Organization
Contact information
Practice address
92 BROAD ST FL 2, GLENS FALLS, NY 12801-4383
(518) 480-4002
Mailing address
92 BROAD ST FL 2, GLENS FALLS, NY 12801-4383
(518) 480-4002
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/11/2022
Last updated
03/11/2022
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