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General NPI Number Information
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NPI Number | 1285023192
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Entity Type | Organization
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Legal Business Name | DASKALAKIS PSYCHOLOGICAL SERVICES, PC
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 317 W 1ST ST SUITE 112
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City | OSWEGO
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State | NY
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Zip | 13126-3623
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Country | US
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Telephone | 315-944-8043
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Fax |
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Provider Business Mailing Address
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Address Line | 317 W 1ST ST SUITE 112
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City | OSWEGO
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State | NY
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Zip | 13126-3623
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Country | US
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Telephone | 315-944-8043
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KATHERINE M. DASKALAKIS
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Credential | PHD
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Telephone | 315-944-8043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 017258
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License Number State | NY
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