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NPI 1194073551

NPI 1194073551 : HANNAH D MONK PSYD : UTICA, NY

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General NPI Number Information
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    NPI Number           |    1194073551
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    Entity Type          |    Individual 
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    Provider Name        |    HANNAH D MONK PSYD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/16/2012
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    Last Update Date     |    07/16/2019
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Provider Practice Location Address
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    Address Line         |    1651 ONEIDA ST 
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    City                 |    UTICA
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    State                |    NY
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    Zip                  |    13501
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    Country              |    US
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    Telephone            |    315-793-7600
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1415 GENESEE ST 
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    City                 |    UTICA
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    State                |    NY
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    Zip                  |    13501-4343
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    022727
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    License Number State |    NY
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