Individual
DR. SIMONE F M COLLYMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
212 FAIR STREET, SUITE 2, KINGSTON, NY 12401
(845) 338-4784
(845) 454-1441
Mailing address
212 FAIR ST, PO BOX 3065, KINGSTON, NY 12402-3065
(845) 338-4784
(845) 454-1441
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
013677
NY
103TC0700X
Clinical Psychologist
013677
NY
Other
Enumeration date
10/04/2006
Last updated
10/08/2009
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