Individual
MARILYN ANN GEWACKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1 COLUMBIA PL, ALBANY, NY 12207-1006
(518) 449-7901
Mailing address
100 WOLFS DEN RD, EAST NASSAU, NY 12062-1909
(518) 449-7901
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
006617-1
NY
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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