Individual
JANE ELLIOTT S DESOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPS, ATR-BC, LCAT
Contact information
Practice address
275 NORTH ST, HARRISON, NY 10528-1524
(914) 925-5290
(914) 925-5174
Mailing address
275 NORTH ST, HARRISON, NY 10528-1524
(914) 925-5290
(914) 925-5174
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
000281-1
NY
103TA0400X
Addiction (Substance Use Disorder) Psychologist
000281-1
NY
103TB0200X
Cognitive & Behavioral Psychologist
Primary
000281-1
NY
103TR0400X
Rehabilitation Psychologist
000281-1
NY
Other
Enumeration date
12/21/2006
Last updated
10/01/2009
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