Healthcare Provider Details

I. General information

NPI: 1497963847
Provider Name (Legal Business Name): CATHERINE ANDERSON-HANLEY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 03/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 USHERS RD STE 8
BALLSTON LAKE NY
12019-1547
US

IV. Provider business mailing address

315 USHERS RD STE 8
BALLSTON LAKE NY
12019-1547
US

V. Phone/Fax

Practice location:
  • Phone: 518-581-7260
  • Fax: 518-633-1218
Mailing address:
  • Phone: 518-581-7260
  • Fax: 518-633-1218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number013031
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number013031
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: