Individual
ELISABETH O'ROURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 CORNELL RD, LATHAM, NY 12110-1491
(518) 510-3100
Mailing address
15 CORNELL RD, LATHAM, NY 12110-1491
(518) 510-3100
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
024385
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/20/2019
Last updated
03/02/2023
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