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General NPI Number Information
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NPI Number | 1104645456
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Entity Type | Organization
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Legal Business Name | PALMO PSYCHOLOGY SERVICES, PLLC
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Dates
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Enumeration Date | 10/04/2024
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Last Update Date | 11/29/2024
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Provider Practice Location Address
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Address Line | 101 LANG BLVD STE 1
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City | GRAND ISLAND
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State | NY
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Zip | 14072-1601
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Country | US
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Telephone | 716-830-5787
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Fax |
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Provider Business Mailing Address
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Address Line | 101 LANG BLVD STE 1
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City | GRAND ISLAND
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State | NY
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Zip | 14072-1601
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Country | US
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Telephone | 716-453-0242
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TRACY KLAPP
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Credential |
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Telephone | 716-453-0242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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