Organization
DR. TODD DENEEN - PSYCHOLOGICAL SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD DENEEN PSY.D. (PRESIDENT)
(585) 749-8372
Entity
Organization
Contact information
Practice address
20 OFFICE PARK WAY STE 125, PITTSFORD, NY 14534-1781
(585) 749-8372
Mailing address
28 LARKSPUR LN, FAIRPORT, NY 14450-9207
(585) 749-8372
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
202C00000X
Independent Medical Examiner Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S22010-3I
WORKER'S COMPENSATION BOARD IME AUTHORIZATION NUMBER
NY
Enumeration date
01/29/2020
Last updated
01/29/2020
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