Individual
DIJANA BLACIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
160 HOWELLS RD STE 2, BAY SHORE, NY 11706-5320
(631) 647-7885
(631) 647-7893
Mailing address
160 HOWELLS RD STE 2, BAY SHORE, NY 11706-5320
(631) 647-7885
(631) 647-7893
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
016908-1
NY
Other
Enumeration date
10/24/2006
Last updated
09/04/2007
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