Individual
JANE OBERWAGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
23 KENILWORTH DR, E NORTHPORT, NY 11731-2536
(631) 261-5413
(631) 261-5413
Mailing address
23 KENILWORTH DR, E NORTHPORT, NY 11731-2536
(631) 261-5413
(631) 261-5413
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
011184-1
NY
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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