Individual
DANIELLE MARIE BRONK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1601 ARMORY DR, UTICA, NY 13501-5405
(315) 797-6241
(315) 738-7777
Mailing address
1020 MARY ST, UTICA, NY 13501-1930
(315) 724-6927
(315) 733-0791
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
017386
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00474180
—
NY
05
—
01039156
—
NY
Enumeration date
12/05/2007
Last updated
09/18/2008
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