Healthcare Provider Details
I. General information
NPI: 1073436614
Provider Name (Legal Business Name): NEUROKIND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2743 DIBBLE RD
CORNING NY
14830-9625
US
IV. Provider business mailing address
2743 DIBBLE RD
CORNING NY
14830-9625
US
V. Phone/Fax
- Phone: 315-749-8143
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DANIELLE
LYNNETTE
TERRY
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 315-749-8143